A patient with HER2-negative metastatic gastric adenocarcinoma progresses after fluoropyrimidine-platinum therapy. ECOG is 1 and second-line

Question

A patient with HER2-negative metastatic gastric adenocarcinoma progresses after fluoropyrimidine-platinum therapy. ECOG is 1 and second-line chemotherapy is appropriate. The MDT proposes ramucirumab plus paclitaxel because it is an international standard. What is the crucial NHS England funding correction?

Accepted Answer

Do not use ramucirumab; select an established single-agent chemotherapy

Answer

Use ramucirumab-paclitaxel as the preferred regimen for ECOG 0 or 1

Answer

Use pembrolizumab rechallenge after progression on platinum-containing first-line treatment

Answer

Use trastuzumab deruxtecan as the default second line for HER2-negative disease

Answer

Use ramucirumab monotherapy because the negative appraisal applies only to the paclitaxel combination

Gastric Cancer — SCE Medical Oncology MCQ