Oesophageal Cancer — SCE Medical Oncology MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: C — Trastuzumab with cisplatin and either capecitabine or fluorouracil
Explanation lettering: B = shown as A · A = shown as B
C is correct. NICE TA208 recommends trastuzumab with cisplatin and capecitabine or fluorouracil for untreated metastatic gastric or gastro-oesophageal junction adenocarcinoma with high HER2 expression defined as IHC 3+. Trastuzumab deruxtecan is used after prior HER2-directed therapy, nivolumab-based chemotherapy does not replace indicated trastuzumab in this molecular subgroup, and TA983 did not recommend adding pembrolizumab to trastuzumab-chemotherapy for NHS use. Chemotherapy alone omits an effective biomarker-directed component. The stem was narrowed from oesophageal adenocarcinoma to the exact gastric or junctional population covered by the appraisal.
Reference: NICE TA208 trastuzumab in HER2-positive metastatic gastric or gastro-oesophageal junction cancer: https://www.nice.org.uk/guidance/ta208/chapter/1-Recommendations