Gastric Cancer   

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

How would the duration of 5FU infusion impact response?

Exploratory analysis of the MAGIC trial suggested perioperative chemotherapy was detrimental in this subset of patients. Has availability of IO altere...

Patients with gastric cancer can acquire new targetable mutations on progression. This could aid in additional treatment options in this group which t...

What other molecular tests do you routinely order on such tumors?

If so, what dose-fractionation regimen do you utilize? What are your target volumes?

Do you rebiopsy or use a liquid assay?

Are there factors that would lead you to select either ramucirumab +/- paclitaxel vs T-Dxd vs chemo?

Would your thinking change if the patient continues to be NED after an unplanned chemo break, e.g. for insurance issues?

Is it necessary to test CPS given the FDA approvals are not contingent on CPS %?  If you do test, do you check 28-8 (nivolumab), 22C3 (pembroliz...

Are there meaningful differences in the CHECKMATE 649 and KEYNOTE 590 studies to guide this decision?

Do you go by FDA approval alone, or incorporate other data into your treatment decisions?  How do you view updated recent presentation of CM-649 ...

Do you view CPS < 1% or 1-4% separately? Do you view the incremental benefit of adding immunotherapy still advantageous given relatively poor outco...

What about for a patient with complete radiographic response who declines surgical management?

What factors would influence your approach?

Are there other treatment variations by clinical subsets (eg tumor location, histology, stage II vs III, other biomarkers) seen in CM577 or other data...

CheckMate 577 only included patients with R0 resection.For R1 resections, guidelines suggest observation vs re-resection only.  

If so, how long do you wait after surgery prior to imaging to avoid post-operative findings?

If you would elect for adjuvant therapy, which study helps guide your choice of regimen?

Is FOLFOX or 5FU acceptable without XRT if D2 resection? 

Provided the patient can have the solitary met treated definitively with SBRT and is otherwise a good surgical candidate

I understand the perioperative trials are not based on tumor regression in cancer cells.

Does the lack of D2 dissection automatically necessitate adjuvant chemoradiation therapy (ie <5 LN obtained)? Would the presence of high risk facto...

Is there a consensus on the MAGIC v. MacDonald debate?