All patients with advanced gastric cancer should undergo genomic biomarker testing for HER2 and other targets in order to determine if they can benefit from treatment with a precision cancer medicine.
Precision cancer medicine utilizes molecular diagnostic testing, including DNA sequencing, to identify cancer-driving abnormalities in a cancer’s genome. Once a genetic abnormality is identified, a specific targeted therapy can be used to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells. Precision cancer medicine uses targeted drugs and immunotherapies engineered to directly attack gastric cancer cells with specific abnormalities, leaving normal cells largely unharmed.
Herceptin® (trastuzumab) is a targeted therapy that interferes with specific pathways involved in the growth or spread of cancer. A protein known as HER2 (human epidermal growth factor receptor contributes to cancer growth and cancers that test positive for HER2 may be treated with a HER2-targeting drug called Herceptin® (trastuzumab). Herceptin can be used alone or in combination with chemotherapy, and can prolong patient survival with advanced, HER2-positive gastric cancer.1
Checkpoint Inhibitors are monoclonal antibodies that helps to restore the body’s immune system in fighting cancer. They create their anti-cancer effects by blocking a specific protein used by cancer cells called the programmed death-1 (PD-1), to escape an attack by the body’s immune system. When PD-1 is blocked or inhibited, cells of the immune system are able to identify cancer cells as a threat and initiate an attack to destroy the cancer.
- Keytruda – The KEYNOTE 059 clinical trial compared Keytruda, Keytruda + chemotherapy and chemotherapy alone in patients with advanced gastric cancer. Keytruda as a single drug was as good as chemotherapy but the combination was no better.2
- Opdivo (nivulomab) was found to produce superior survival duration compared to placebo in patients with advanced gastric cancer.3
1 Bang Y-J, Van Cutsem E, Feyereislova A et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010; 376:687-697.
2 Abstract LBA28_PR ‘KEYNOTE-059 Update: Efficacy and Safety of Pembrolizumab Alone or in Combination With Chemotherapy in Patients With Advanced Gastric or Gastroesophageal (G/GEJ) cancer.