What is your preferred first-line treatment for metastatic gastric adenocarcinoma that is PD-L1 CPS ≥ 10 and also HER2+?

We all need to work together and bring the KEYNOTE-811 regimen to the neoadjuvant setting for HER2+ gastroesophageal adenocarcinoma patients. Giving FLOT4 to HER2+ gastric or GEJ carcinoma patients doesn't make much sense in the post-KN-811 era... but we need data.

As of August 25, 2026, trastuzumab has been replaced in the first-line setting based on the FDA approval of zanidatamab, a bispecific/biparatopic antibody against 2 epitopes of HER2. This approval was based on the results of the HERIZON-GEA-01 study, which randomized patients to the control arm of t...

It is premature to state that “based on the results of the HERIZON-GEA-01 study, the new standard-of-care for HER2-positive esophagogastric cancer irrespective of PD-L1 status is zanidatamab/ chemotherapy +/- tislelizumab” for several reasons:

First, the retrieved FDA Orange Book listing for zanidata...