How would you treat newly diagnosed stage IV GEJ adenocarcinoma with both Claudin 18.2 and HER2 (3+ via IHC) overexpression?
Previously untreated, stage IV GE junction adenocarcinoma with overexpression of HER2 (3+ via IHC) as well as Claudin 18.2. What is the best approach, since the GLOW trial excluded patients with HER2-positive disease? Is there any data on combining FOLFOX with both Zolbetuximab and Trastuzumab?
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What is your preferred treatment for metastatic GEJ adenocarcinoma with both claudin 18.2 and HER2 (3+) overexpression?
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2 Answers
Mednet MemberInvited Expert
Medical Oncology · Mayo Clinic
Answered on
Would treat as any other HER+3. FOLFOX+Trastuzumab and add pembrolizumab only if PDL1+. Given the lack of data, would not add zolbe.
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Mednet MemberInvited Expert
Medical Oncology · Rutgers Cancer Institute of New Jersey
Answered on
At present, I would use the HER-2-directed antibodies and ADCs for the treatment of this patient. The Zolbetuximab studies have specifically excluded patients with HER-2 overexpressing gastric cancers. Therefore, we do not have any data to know if anti-Claudin antibodies are as effective in this gro...
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