• Ziqi Yue, PharmD

New Developments in Stomach Cancer Treatments

Stomach cancer is the second most common cancer in men and the fifth most common cancer in women in China (Cancer Communications, 2019). Standard treatment in stage 0-3 stomach cancer involves surgery. In stomach cancer that has metastasized, chemotherapy is used as the main treatment to slow cancer growth and prolong patients’ lives (American Cancer Society, 2019).

Additional treatments with proven efficacy have been developed to achieve better outcomes. To decide the appropriate treatment for stomach cancer, biomarker testing is recommended by the National Comprehensive Cancer Network (NCCN). Biomarker testing helps in making treatment decisions because it indicates the mutation that contributed to the cancer. In stomach cancer, the recommended biomarkers to be tested are: human epidermal growth factor receptor 2 (HER2), programmed death-ligand 1 (PD-L1), and Microsatellite instability high/deficient mismatch repair (MSI-H/dMMR).

Various therapies have been designed to target these mutations. Three targeted therapies recommended by NCCN to treat stomach cancer include Herceptin® (trastuzumab), Cyramza® (ramucirumab), and Keytruda® (pembrolizumab) (NCCN, 2019). Herceptin® is a preferred first-line therapy approved in HER2-overexpressing metastatic stomach cancer and gastroesophageal junction (GEJ) cancer patients (Herceptin® FDA Label, 2010). Cyramza® targets a protein named vascular endothelial growth factor receptor (VEGFR). It is approved to be used in stomach cancer patients who have previously received chemotherapy (Cyramza® FDA Label, 2014). Keytruda®, which targets MSI-H/dMMR and PD-1, is a subsequent therapy for both MSI-H/dMMR tumors and gastric cancer with PD-L1 expression (NCCN, 2019). In NTRK-gene fusion positive stomach cancer patients, Rozlytrek ® (entrectinib) or Vitrakvi® (larotrectinib) are recommended by the NCCN (Rozlytrek FDA Label, 2019; Vitrakvi FDA Label, 2020).

While there are now more targeted therapies and immunotherapies developed to treat cancers, chemotherapy remains a part of standard treatment for stomach cancers due to its efficacy. Scientists are actively working on developing more advanced chemotherapy to help individuals fight cancers. For example, Lonsurf® (tipiracil/trifluridine) was approved in 2019 to treat metastatic gastric cancer and gastroesophageal junction (GEJ) cancer in patients who had been treated with at least two chemotherapies previously (National Institutes of Health, 2019). A double-blinded randomized clinical trial has shown a median survival of 5.7 months when taking Lonsurf® (The Lancet Oncology, 2018).

Looking to learn more about new stomach cancer treatments and therapies? ContactRangeLight Health today to receive a personalized second opinion from an U.S.-based expert cancer specialist.

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