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GOJ Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersGOJ CancerSCE Medical Oncology

A 65-year-old man with metastatic gastro-oesophageal junction adenocarcinoma has molecular profiling showing HER2 IHC 3+ and PD-L1 CPS 8. He is starting first-line therapy. Recent trials suggest which novel first-line approach for HER2+ GOJ cancer?

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Correct answer: A — Pembrolizumab + trastuzumab + chemotherapy

The KEYNOTE-811 trial demonstrated that adding pembrolizumab to trastuzumab + chemotherapy significantly improved PFS and OS compared with trastuzumab + chemotherapy alone in HER2-positive advanced gastric/GOJ cancer. NICE appraisal is pending/approved. This represents the integration of dual HER2-directed and immune checkpoint therapy in first-line gastric cancer. PD-L1 CPS ≥1 subgroup showed the greatest benefit.

Reference: ESMO 2024 Gastric Cancer Guidelines; KEYNOTE-811 Janjigian et al Nature 2024