Overview
Metastatic malignant neoplasm to the esophagus refers to cancer that has spread from another part of the body to the esophagus. This is distinct from primary esophageal cancer.Diagnosis
No specific diagnostic criteria or grading are mentioned in the provided abstracts.Management
HER2-negative gastric adenocarcinoma (AC) and PD-L1 CPS ≥ 5: First-line therapy with nivolumab and chemotherapy (CT) is recommended 1.
HER2-negative esophageal or gastroesophageal junction (GEJ) AC and PD-L1 CPS ≥ 5: First-line therapy with nivolumab and CT is recommended 1.
HER2-negative esophageal or GEJ AC and PD-L1 CPS ≥ 10: First-line therapy with pembrolizumab and CT is recommended 1.
Esophageal squamous cell carcinoma and PD-L1 tumor proportion score ≥ 1%: Nivolumab plus CT, or nivolumab plus ipilimumab is recommended 1.
Esophageal squamous cell carcinoma and PD-L1 CPS ≥ 10: Pembrolizumab plus CT is recommended 1.
HER2-positive gastric or GEJ unresectable or metastatic AC (previously untreated): Trastuzumab plus pembrolizumab in combination with CT is recommended 1.
Advanced gastroesophageal or GEJ AC progressing after first-line therapy: Regimens are mentioned but not detailed 1.Special Populations
No information is available in the provided abstracts.Key Recommendations
For HER2-negative patients with esophageal or gastroesophageal junction (GEJ) AC and PD-L1 CPS ≥ 5, first-line therapy with nivolumab and chemotherapy (CT) is recommended 1. (Evidence: Strong)
For patients with esophageal squamous cell carcinoma and PD-L1 tumor proportion score ≥ 1%, nivolumab plus CT, or nivolumab plus ipilimumab is recommended 1. (Evidence: Strong)
For patients with HER2-positive gastric or GEJ previously untreated, unresectable or metastatic AC, trastuzumab plus pembrolizumab is recommended, in combination with CT 1. (Evidence: Strong)References
1 Shah MA, Kennedy EB, Alarcon-Rozas AE, Alcindor T, Bartley AN, Malowany AB et al.. Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2023. link