Oncology Brothers: Practice-Changing Cancer Discussions

Current Treatment Landscape of Advanced Gastric/Esophageal/GEJ Adenocarcinoma – Dr. Rutika Mehta

Dec 15, 2025

Dr. Rutika Mehta, a GI medical oncologist at Weill Cornell, shares her expertise on advanced gastroesophageal cancers. She discusses the recent approval of durvalumab for resectable disease and the critical role of biomarker testing, particularly HER2, in treatment decisions. Insights into frontline therapies for HER2-positive patients and the significance of retesting HER2 upon disease progression are highlighted. Emerging treatments like TDXd and Zanidatamab also get attention, alongside considerations for managing side effects and treatment sequencing.

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INSIGHT

Perioperative Durvalumab And Biomarker Focus

Perioperative durvalumab plus FLOT improved overall survival in resectable disease (MATTERHORN).
Frontline metastatic decisions now hinge on CPS, HER2, and CLDN18.2 testing.

ADVICE

Use Guideline HER2 And PD-L1 Testing

Test HER2 by ASCO/CAP IHC 3+ or IHC2+ with ISH ratio >2 to define positivity.
If PD-L1 CPS ≥1, add pembrolizumab to chemo+trastuzumab; if CPS<1, use chemo+trastuzumab alone.

ADVICE

Plan For Changing Anti‑HER2 Sequencing

Anticipate new anti‑HER2 agents (zanidatamab, T-DXd) and trial results to reshape sequencing.
Prioritize enrollment in trials and plan sequencing to manage efficacy and toxicities.

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Welcome to the Oncology Brothers podcast! In this episode, we were joined by Dr. Rutika Mehta, a GI medical oncologist from Weill Cornell. Together, we dived into the current treatment landscape for advanced metastatic gastroesophageal junction (GEJ) and gastrointestinal carcinoma, with a special focus on HER2-positive disease.

Episode Highlights:
• Overview of recent advancements in the treatment of resectable disease, including the approval of Durvalumab in perioperative settings.
• Discussion on the importance of biomarker testing, including HER2, PD-L1, MMR, and Claudin 18.2, in determining treatment options.
• Insights into frontline treatment strategies for HER2-positive patients, including the role of trastuzumab and the addition of pembrolizumab based on PD-L1 status.
• The significance of retesting HER2 expression upon disease progression and the implications for treatment decisions.
• Exploration of emerging therapies like TDXd and Zanidatamab, and their potential impact on the treatment landscape.
• Considerations for managing side effects and the importance of treatment sequencing in palliative care.

Join us for an informative discussion that aims to keep community oncologists up to date in this ever-evolving field of cancer treatment.

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Accreditation/Credit Designation
Physicians’ Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians’ Education Resource®, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Acknowledgment of Commercial Support
This activity is supported by an educational grant from Jazz Pharmaceuticals, Inc.

Link to gain CME credits from this activity:
https://www.gotoper.com/courses/biomarker-testing-in-her2-gea-diagnosis-and-treatment-implications

#HER2GastricCancer #GastricCancer #BiomarkerTesting #OncologyBrothers #GIOncology #CME