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Locally Advanced Unresectable Gastric Adenocarcinoma

MedGen UID:
1657181
•Concept ID:
C4744429
•
Neoplastic Process

Definition

A gastric adenocarcinoma that has spread from its original site of growth to nearby tissues or lymph nodes and is not amenable to surgical resection. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVLocally Advanced 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
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
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

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
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
Neoadjuvant chemotherapy for gastric adenocarcinoma in Japan.
Kodera Y
Surg Today 2017 Aug;47(8):899-907. Epub 2017 Feb 28 doi: 10.1007/s00595-017-1473-2. PMID: 28247105

Diagnosis

Sintilimab Plus Chemotherapy for Unresectable Gastric or Gastroesophageal Junction Cancer: The ORIENT-16 Randomized Clinical Trial.
Xu J, Jiang H, Pan Y, Gu K, Cang S, Han L, Shu Y, Li J, Zhao J, Pan H, Luo S, Qin Y, Guo Q, Bai Y, Ling Y, Yang J, Yan Z, Yang L, Tang Y, He Y, Zhang L, Liang X, Niu Z, Zhang J, Mao Y, Guo Y, Peng B, Li Z, Liu Y, Wang Y, Zhou H; ORIENT-16 Investigators
JAMA 2023 Dec 5;330(21):2064-2074. doi: 10.1001/jama.2023.19918. PMID: 38051328Free PMC Article
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
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

Sintilimab Plus Chemotherapy for Unresectable Gastric or Gastroesophageal Junction Cancer: The ORIENT-16 Randomized Clinical Trial.
Xu J, Jiang H, Pan Y, Gu K, Cang S, Han L, Shu Y, Li J, Zhao J, Pan H, Luo S, Qin Y, Guo Q, Bai Y, Ling Y, Yang J, Yan Z, Yang L, Tang Y, He Y, Zhang L, Liang X, Niu Z, Zhang J, Mao Y, Guo Y, Peng B, Li Z, Liu Y, Wang Y, Zhou H; ORIENT-16 Investigators
JAMA 2023 Dec 5;330(21):2064-2074. doi: 10.1001/jama.2023.19918. PMID: 38051328Free PMC Article
Zolbetuximab plus CAPOX in CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 GLOW trial.
Shah MA, Shitara K, Ajani JA, Bang YJ, Enzinger P, Ilson D, Lordick F, Van Cutsem E, Gallego Plazas J, Huang J, Shen L, Oh SC, Sunpaweravong P, Soo Hoo HF, Turk HM, Oh M, Park JW, Moran D, Bhattacharya P, Arozullah A, Xu RH
Nat Med 2023 Aug;29(8):2133-2141. Epub 2023 Jul 31 doi: 10.1038/s41591-023-02465-7. PMID: 37524953Free PMC Article
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
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
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

Prognosis

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
Prevalence and prognosis of microsatellite instability in oesogastric adenocarcinoma, NORDICAP 16-01.
Tran-Minh ML, Lehmann-Che J, Lambert J, Theou-Anton N, Poté N, Dior M, Mary F, Goujon G, Gardair C, Schischmanoff O, Kaci R, Cucherousset N, Bertheau P, Couvelard A, Aparicio T; for NORDICAP
Clin Res Hepatol Gastroenterol 2021 Jul;45(4):101691. Epub 2021 Apr 20 doi: 10.1016/j.clinre.2021.101691. PMID: 33852952
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
Neoadjuvant chemotherapy for gastric adenocarcinoma in Japan.
Kodera Y
Surg Today 2017 Aug;47(8):899-907. Epub 2017 Feb 28 doi: 10.1007/s00595-017-1473-2. PMID: 28247105

Clinical prediction guides

Sintilimab Plus Chemotherapy for Unresectable Gastric or Gastroesophageal Junction Cancer: The ORIENT-16 Randomized Clinical Trial.
Xu J, Jiang H, Pan Y, Gu K, Cang S, Han L, Shu Y, Li J, Zhao J, Pan H, Luo S, Qin Y, Guo Q, Bai Y, Ling Y, Yang J, Yan Z, Yang L, Tang Y, He Y, Zhang L, Liang X, Niu Z, Zhang J, Mao Y, Guo Y, Peng B, Li Z, Liu Y, Wang Y, Zhou H; ORIENT-16 Investigators
JAMA 2023 Dec 5;330(21):2064-2074. doi: 10.1001/jama.2023.19918. PMID: 38051328Free PMC Article
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
Safety and efficacy of HER2 blockade by trastuzumab-based chemotherapy-containing combination strategies in HER2+ gastroesophageal adenocarcinoma.
Catenacci DVT, Chung HC, Shen L, Moehler M, Yoon HH, Rosales MK, Kang YK
ESMO Open 2022 Feb;7(1):100360. Epub 2021 Dec 29 doi: 10.1016/j.esmoop.2021.100360. PMID: 34973512Free PMC Article
Margetuximab plus pembrolizumab in patients with previously treated, HER2-positive gastro-oesophageal adenocarcinoma (CP-MGAH22-05): a single-arm, phase 1b-2 trial.
Catenacci DVT, Kang YK, Park H, Uronis HE, Lee KW, Ng MCH, Enzinger PC, Park SH, Gold PJ, Lacy J, Hochster HS, Oh SC, Kim YH, Marrone KA, Kelly RJ, Juergens RA, Kim JG, Bendell JC, Alcindor T, Sym SJ, Song EK, Chee CE, Chao Y, Kim S, Lockhart AC, Knutson KL, Yen J, Franovic A, Nordstrom JL, Li D, Wigginton J, Davidson-Moncada JK, Rosales MK, Bang YJ; CP-MGAH22-5 Study Group
Lancet Oncol 2020 Aug;21(8):1066-1076. Epub 2020 Jul 9 doi: 10.1016/S1470-2045(20)30326-0. PMID: 32653053
Preoperative chemotherapy of locally advanced gastric cancer.
Rougier P, Lasser P, Ducreux M, Mahjoubi M, Bognel C, Elias D
Ann Oncol 1994;5 Suppl 3:59-68. doi: 10.1093/annonc/5.suppl_3.s59. PMID: 8204531

Recent systematic reviews

Efficacy and safety of Zolbetuximab plus chemotherapy for advanced CLDN18.2-positive gastric or gastro-oesophageal adenocarcinoma: a meta-analysis of randomized clinical trials.
de Moraes FCA, Pasqualotto E, Chavez MP, Ferreira ROM, De Castria TB, Burbano RMR
BMC Cancer 2024 Feb 21;24(1):240. doi: 10.1186/s12885-024-11980-w. PMID: 38383390Free PMC Article
Overview of different available chemotherapy regimens combined with radiotherapy for the neoadjuvant and definitive treatment of esophageal cancer.
Tomasello G, Ghidini M, Barni S, Passalacqua R, Petrelli F
Expert Rev Clin Pharmacol 2017 Jun;10(6):649-660. Epub 2017 Apr 10 doi: 10.1080/17512433.2017.1313112. PMID: 28349718

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