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

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 disease emerges, t...