How would you manage HER2+ GEJ adenocarcinoma that recurs as a single 1.6cm lung nodule a year after completing primary chemoradiation and esophagectomy?

If biopsy of the lesion is consistent with GI origin adenocarcinoma and there are no other sites of disease, would wedge resection followed by adjuvant FOLFOX + herceptin be reasonable and for how many cycles?

Answer from: Medical Oncologist at Academic Institution

It is always best with upper GI cancers to assume that there is more disease than meets the eye. Despite the presence of a single lesion on imaging, I would favor systemic chemotherapy with FOLFOX + trasutuzmab (or clinical trial) upfront. If, after 6 months of treatment, no other diseas...

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How would you manage HER2+ GEJ adenocarcinoma that recurs as a single 1.6cm lung nodule a year after completing primary chemoradiation and esophagectomy?

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