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Metastatic Unresectable Gastric Adenocarcinoma

MedGen UID:
1653879
•Concept ID:
C4727167
•
Neoplastic Process

Definition

A gastric adenocarcinoma that has spread from its original site of growth to another anatomic site and is not amenable to surgical resection. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMetastatic Unresectable Gastric Adenocarcinoma

Professional guidelines

PubMed

Esophageal and Esophagogastric Junction Cancers, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology.
Ajani JA, D'Amico TA, Bentrem DJ, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Farjah F, Gerdes H, Gibson M, Grierson P, Hofstetter WL, Ilson DH, Jalal S, Keswani RN, Kim S, Kleinberg LR, Klempner S, Lacy J, Licciardi F, Ly QP, Matkowskyj KA, McNamara M, Miller A, Mukherjee S, Mulcahy MF, Outlaw D, Perry KA, Pimiento J, Poultsides GA, Reznik S, Roses RE, Strong VE, Su S, Wang HL, Wiesner G, Willett CG, Yakoub D, Yoon H, McMillian NR, Pluchino LA
J Natl Compr Canc Netw 2023 Apr;21(4):393-422. doi: 10.6004/jnccn.2023.0019. PMID: 37015332
Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline.
Shah MA, Kennedy EB, Alarcon-Rozas AE, Alcindor T, Bartley AN, Malowany AB, Bhadkamkar NA, Deighton DC, Janjigian Y, Karippot A, Khan U, King DA, Klute K, Lacy J, Lee JJ, Mehta R, Mukherjee S, Nagarajan A, Park H, Saeed A, Semrad TJ, Shitara K, Smyth E, Uboha NV, Vincelli M, Wainberg Z, Rajdev L
J Clin Oncol 2023 Mar 1;41(7):1470-1491. Epub 2023 Jan 5 doi: 10.1200/JCO.22.02331. PMID: 36603169
Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.
Ajani JA, D'Amico TA, Bentrem DJ, Chao J, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Fanta P, Farjah F, Gerdes H, Gibson MK, Hochwald S, Hofstetter WL, Ilson DH, Keswani RN, Kim S, Kleinberg LR, Klempner SJ, Lacy J, Ly QP, Matkowskyj KA, McNamara M, Mulcahy MF, Outlaw D, Park H, Perry KA, Pimiento J, Poultsides GA, Reznik S, Roses RE, Strong VE, Su S, Wang HL, Wiesner G, Willett CG, Yakoub D, Yoon H, McMillian N, Pluchino LA
J Natl Compr Canc Netw 2022 Feb;20(2):167-192. doi: 10.6004/jnccn.2022.0008. PMID: 35130500

Recent clinical studies

Etiology

Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial.
Shitara K, Lordick F, Bang YJ, Enzinger P, Ilson D, Shah MA, Van Cutsem E, Xu RH, Aprile G, Xu J, Chao J, Pazo-Cid R, Kang YK, Yang J, Moran D, Bhattacharya P, Arozullah A, Park JW, Oh M, Ajani JA
Lancet 2023 May 20;401(10389):1655-1668. Epub 2023 Apr 15 doi: 10.1016/S0140-6736(23)00620-7. PMID: 37068504
Frequency and therapeutic strategy for patients with ovarian metastasis from gastric cancer.
Namikawa T, Marui A, Yokota K, Kawanishi Y, Munekage M, Uemura S, Maeda H, Kitagawa H, Kobayashi M, Hanazaki K
Langenbecks Arch Surg 2022 Sep;407(6):2301-2308. Epub 2022 May 13 doi: 10.1007/s00423-022-02543-3. PMID: 35551466
Efficacy and safety of weekly paclitaxel with or without ramucirumab as second-line therapy for the treatment of advanced gastric or gastroesophageal junction adenocarcinoma (RAINBOW-Asia): a randomised, multicentre, double-blind, phase 3 trial.
Xu RH, Zhang Y, Pan H, Feng J, Zhang T, Liu T, Qin Y, Qin S, Yin X, Liu B, Ba Y, Yang N, Voon PJ, Tanasanvimon S, Zhou C, Zhang WL, Shen L
Lancet Gastroenterol Hepatol 2021 Dec;6(12):1015-1024. Epub 2021 Oct 7 doi: 10.1016/S2468-1253(21)00313-7. PMID: 34626550
First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial.
Janjigian YY, Shitara K, Moehler M, Garrido M, Salman P, Shen L, Wyrwicz L, Yamaguchi K, Skoczylas T, Campos Bragagnoli A, Liu T, Schenker M, Yanez P, Tehfe M, Kowalyszyn R, Karamouzis MV, Bruges R, Zander T, Pazo-Cid R, Hitre E, Feeney K, Cleary JM, Poulart V, Cullen D, Lei M, Xiao H, Kondo K, Li M, Ajani JA
Lancet 2021 Jul 3;398(10294):27-40. Epub 2021 Jun 5 doi: 10.1016/S0140-6736(21)00797-2. PMID: 34102137Free PMC Article
Trastuzumab emtansine versus taxane use for previously treated HER2-positive locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma (GATSBY): an international randomised, open-label, adaptive, phase 2/3 study.
Thuss-Patience PC, Shah MA, Ohtsu A, Van Cutsem E, Ajani JA, Castro H, Mansoor W, Chung HC, Bodoky G, Shitara K, Phillips GDL, van der Horst T, Harle-Yge ML, Althaus BL, Kang YK
Lancet Oncol 2017 May;18(5):640-653. Epub 2017 Mar 23 doi: 10.1016/S1470-2045(17)30111-0. PMID: 28343975

Diagnosis

Esophageal and Esophagogastric Junction Cancers, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology.
Ajani JA, D'Amico TA, Bentrem DJ, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Farjah F, Gerdes H, Gibson M, Grierson P, Hofstetter WL, Ilson DH, Jalal S, Keswani RN, Kim S, Kleinberg LR, Klempner S, Lacy J, Licciardi F, Ly QP, Matkowskyj KA, McNamara M, Miller A, Mukherjee S, Mulcahy MF, Outlaw D, Perry KA, Pimiento J, Poultsides GA, Reznik S, Roses RE, Strong VE, Su S, Wang HL, Wiesner G, Willett CG, Yakoub D, Yoon H, McMillian NR, Pluchino LA
J Natl Compr Canc Netw 2023 Apr;21(4):393-422. doi: 10.6004/jnccn.2023.0019. PMID: 37015332
Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.
Ajani JA, D'Amico TA, Bentrem DJ, Chao J, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Fanta P, Farjah F, Gerdes H, Gibson MK, Hochwald S, Hofstetter WL, Ilson DH, Keswani RN, Kim S, Kleinberg LR, Klempner SJ, Lacy J, Ly QP, Matkowskyj KA, McNamara M, Mulcahy MF, Outlaw D, Park H, Perry KA, Pimiento J, Poultsides GA, Reznik S, Roses RE, Strong VE, Su S, Wang HL, Wiesner G, Willett CG, Yakoub D, Yoon H, McMillian N, Pluchino LA
J Natl Compr Canc Netw 2022 Feb;20(2):167-192. doi: 10.6004/jnccn.2022.0008. PMID: 35130500
Efficacy and safety of weekly paclitaxel with or without ramucirumab as second-line therapy for the treatment of advanced gastric or gastroesophageal junction adenocarcinoma (RAINBOW-Asia): a randomised, multicentre, double-blind, phase 3 trial.
Xu RH, Zhang Y, Pan H, Feng J, Zhang T, Liu T, Qin Y, Qin S, Yin X, Liu B, Ba Y, Yang N, Voon PJ, Tanasanvimon S, Zhou C, Zhang WL, Shen L
Lancet Gastroenterol Hepatol 2021 Dec;6(12):1015-1024. Epub 2021 Oct 7 doi: 10.1016/S2468-1253(21)00313-7. PMID: 34626550
KEYNOTE-859: a Phase III study of pembrolizumab plus chemotherapy in gastric/gastroesophageal junction adenocarcinoma.
Tabernero J, Bang YJ, Van Cutsem E, Fuchs CS, Janjigian YY, Bhagia P, Li K, Adelberg D, Qin SK
Future Oncol 2021 Aug;17(22):2847-2855. Epub 2021 May 12 doi: 10.2217/fon-2021-0176. PMID: 33975465Free PMC Article
Role of Chemotherapy and Radiation Therapy in the Management of Gastric Adenocarcinoma.
Spiegel D, Palta M, Uronis H
Surg Clin North Am 2017 Apr;97(2):421-435. doi: 10.1016/j.suc.2016.11.013. PMID: 28325195

Therapy

Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial.
Shitara K, Lordick F, Bang YJ, Enzinger P, Ilson D, Shah MA, Van Cutsem E, Xu RH, Aprile G, Xu J, Chao J, Pazo-Cid R, Kang YK, Yang J, Moran D, Bhattacharya P, Arozullah A, Park JW, Oh M, Ajani JA
Lancet 2023 May 20;401(10389):1655-1668. Epub 2023 Apr 15 doi: 10.1016/S0140-6736(23)00620-7. PMID: 37068504
Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline.
Shah MA, Kennedy EB, Alarcon-Rozas AE, Alcindor T, Bartley AN, Malowany AB, Bhadkamkar NA, Deighton DC, Janjigian Y, Karippot A, Khan U, King DA, Klute K, Lacy J, Lee JJ, Mehta R, Mukherjee S, Nagarajan A, Park H, Saeed A, Semrad TJ, Shitara K, Smyth E, Uboha NV, Vincelli M, Wainberg Z, Rajdev L
J Clin Oncol 2023 Mar 1;41(7):1470-1491. Epub 2023 Jan 5 doi: 10.1200/JCO.22.02331. PMID: 36603169
The KEYNOTE-811 trial of dual PD-1 and HER2 blockade in HER2-positive gastric cancer.
Janjigian YY, Kawazoe A, Yañez P, Li N, Lonardi S, Kolesnik O, Barajas O, Bai Y, Shen L, Tang Y, Wyrwicz LS, Xu J, Shitara K, Qin S, Van Cutsem E, Tabernero J, Li L, Shah S, Bhagia P, Chung HC
Nature 2021 Dec;600(7890):727-730. Epub 2021 Dec 15 doi: 10.1038/s41586-021-04161-3. PMID: 34912120Free PMC Article
First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial.
Janjigian YY, Shitara K, Moehler M, Garrido M, Salman P, Shen L, Wyrwicz L, Yamaguchi K, Skoczylas T, Campos Bragagnoli A, Liu T, Schenker M, Yanez P, Tehfe M, Kowalyszyn R, Karamouzis MV, Bruges R, Zander T, Pazo-Cid R, Hitre E, Feeney K, Cleary JM, Poulart V, Cullen D, Lei M, Xiao H, Kondo K, Li M, Ajani JA
Lancet 2021 Jul 3;398(10294):27-40. Epub 2021 Jun 5 doi: 10.1016/S0140-6736(21)00797-2. PMID: 34102137Free PMC Article
KEYNOTE-859: a Phase III study of pembrolizumab plus chemotherapy in gastric/gastroesophageal junction adenocarcinoma.
Tabernero J, Bang YJ, Van Cutsem E, Fuchs CS, Janjigian YY, Bhagia P, Li K, Adelberg D, Qin SK
Future Oncol 2021 Aug;17(22):2847-2855. Epub 2021 May 12 doi: 10.2217/fon-2021-0176. PMID: 33975465Free PMC Article

Prognosis

Trastuzumab Deruxtecan: A Review in Gastric or Gastro-Oesophageal Junction Adenocarcinoma.
Kang C
Target Oncol 2023 Nov;18(6):981-989. Epub 2023 Oct 3 doi: 10.1007/s11523-023-00998-y. PMID: 37787931
Esophageal and Esophagogastric Junction Cancers, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology.
Ajani JA, D'Amico TA, Bentrem DJ, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Farjah F, Gerdes H, Gibson M, Grierson P, Hofstetter WL, Ilson DH, Jalal S, Keswani RN, Kim S, Kleinberg LR, Klempner S, Lacy J, Licciardi F, Ly QP, Matkowskyj KA, McNamara M, Miller A, Mukherjee S, Mulcahy MF, Outlaw D, Perry KA, Pimiento J, Poultsides GA, Reznik S, Roses RE, Strong VE, Su S, Wang HL, Wiesner G, Willett CG, Yakoub D, Yoon H, McMillian NR, Pluchino LA
J Natl Compr Canc Netw 2023 Apr;21(4):393-422. doi: 10.6004/jnccn.2023.0019. PMID: 37015332
Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.
Ajani JA, D'Amico TA, Bentrem DJ, Chao J, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Fanta P, Farjah F, Gerdes H, Gibson MK, Hochwald S, Hofstetter WL, Ilson DH, Keswani RN, Kim S, Kleinberg LR, Klempner SJ, Lacy J, Ly QP, Matkowskyj KA, McNamara M, Mulcahy MF, Outlaw D, Park H, Perry KA, Pimiento J, Poultsides GA, Reznik S, Roses RE, Strong VE, Su S, Wang HL, Wiesner G, Willett CG, Yakoub D, Yoon H, McMillian N, Pluchino LA
J Natl Compr Canc Netw 2022 Feb;20(2):167-192. doi: 10.6004/jnccn.2022.0008. PMID: 35130500
Current status and future perspectives in HER2 positive advanced gastric cancer.
Roviello G, Catalano M, Iannone LF, Marano L, Brugia M, Rossi G, Aprile G, Antonuzzo L
Clin Transl Oncol 2022 Jun;24(6):981-996. Epub 2022 Jan 29 doi: 10.1007/s12094-021-02760-0. PMID: 35091998
Trastuzumab emtansine versus taxane use for previously treated HER2-positive locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma (GATSBY): an international randomised, open-label, adaptive, phase 2/3 study.
Thuss-Patience PC, Shah MA, Ohtsu A, Van Cutsem E, Ajani JA, Castro H, Mansoor W, Chung HC, Bodoky G, Shitara K, Phillips GDL, van der Horst T, Harle-Yge ML, Althaus BL, Kang YK
Lancet Oncol 2017 May;18(5):640-653. Epub 2017 Mar 23 doi: 10.1016/S1470-2045(17)30111-0. PMID: 28343975

Clinical prediction guides

Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial.
Shitara K, Lordick F, Bang YJ, Enzinger P, Ilson D, Shah MA, Van Cutsem E, Xu RH, Aprile G, Xu J, Chao J, Pazo-Cid R, Kang YK, Yang J, Moran D, Bhattacharya P, Arozullah A, Park JW, Oh M, Ajani JA
Lancet 2023 May 20;401(10389):1655-1668. Epub 2023 Apr 15 doi: 10.1016/S0140-6736(23)00620-7. PMID: 37068504
Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline.
Shah MA, Kennedy EB, Alarcon-Rozas AE, Alcindor T, Bartley AN, Malowany AB, Bhadkamkar NA, Deighton DC, Janjigian Y, Karippot A, Khan U, King DA, Klute K, Lacy J, Lee JJ, Mehta R, Mukherjee S, Nagarajan A, Park H, Saeed A, Semrad TJ, Shitara K, Smyth E, Uboha NV, Vincelli M, Wainberg Z, Rajdev L
J Clin Oncol 2023 Mar 1;41(7):1470-1491. Epub 2023 Jan 5 doi: 10.1200/JCO.22.02331. PMID: 36603169
First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial.
Janjigian YY, Shitara K, Moehler M, Garrido M, Salman P, Shen L, Wyrwicz L, Yamaguchi K, Skoczylas T, Campos Bragagnoli A, Liu T, Schenker M, Yanez P, Tehfe M, Kowalyszyn R, Karamouzis MV, Bruges R, Zander T, Pazo-Cid R, Hitre E, Feeney K, Cleary JM, Poulart V, Cullen D, Lei M, Xiao H, Kondo K, Li M, Ajani JA
Lancet 2021 Jul 3;398(10294):27-40. Epub 2021 Jun 5 doi: 10.1016/S0140-6736(21)00797-2. PMID: 34102137Free PMC Article
KEYNOTE-859: a Phase III study of pembrolizumab plus chemotherapy in gastric/gastroesophageal junction adenocarcinoma.
Tabernero J, Bang YJ, Van Cutsem E, Fuchs CS, Janjigian YY, Bhagia P, Li K, Adelberg D, Qin SK
Future Oncol 2021 Aug;17(22):2847-2855. Epub 2021 May 12 doi: 10.2217/fon-2021-0176. PMID: 33975465Free PMC Article
Efficacy and Safety of Pembrolizumab for Heavily Pretreated Patients With Advanced, Metastatic Adenocarcinoma or Squamous Cell Carcinoma of the Esophagus: The Phase 2 KEYNOTE-180 Study.
Shah MA, Kojima T, Hochhauser D, Enzinger P, Raimbourg J, Hollebecque A, Lordick F, Kim SB, Tajika M, Kim HT, Lockhart AC, Arkenau HT, El-Hajbi F, Gupta M, Pfeiffer P, Liu Q, Lunceford J, Kang SP, Bhagia P, Kato K
JAMA Oncol 2019 Apr 1;5(4):546-550. doi: 10.1001/jamaoncol.2018.5441. PMID: 30570649Free PMC Article

Recent systematic reviews

Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline.
Shah MA, Kennedy EB, Alarcon-Rozas AE, Alcindor T, Bartley AN, Malowany AB, Bhadkamkar NA, Deighton DC, Janjigian Y, Karippot A, Khan U, King DA, Klute K, Lacy J, Lee JJ, Mehta R, Mukherjee S, Nagarajan A, Park H, Saeed A, Semrad TJ, Shitara K, Smyth E, Uboha NV, Vincelli M, Wainberg Z, Rajdev L
J Clin Oncol 2023 Mar 1;41(7):1470-1491. Epub 2023 Jan 5 doi: 10.1200/JCO.22.02331. PMID: 36603169
Efficacy of stereotactic body radiotherapy for unresectable or recurrent cholangiocarcinoma: a meta-analysis and systematic review.
Lee J, Yoon WS, Koom WS, Rim CH
Strahlenther Onkol 2019 Feb;195(2):93-102. Epub 2018 Sep 11 doi: 10.1007/s00066-018-1367-2. PMID: 30206644

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