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Ref Type
PMID (38458658)
Authors Shitara K, Fleitas T, Kawakami H, Curigliano G, Narita Y, Wang F, Wardhani SO, Basade M, Rha SY, Wan Zamaniah WI, Sacdalan DL, Ng M, Yeh KH, Sunpaweravong P, Sirachainan E, Chen MH, Yong WP, Peneyra JL, Ibtisam MN, Lee KW, Krishna V, Pribadi RR, Li J, Lui A, Yoshino T, Baba E, Nakayama I, Pentheroudakis G, Shoji H, Cervantes A, Ishioka C, Smyth E
Title Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with gastric cancer.
Journal Vol Issue Date Pages Journal Short Title
ESMO open 9 2 2024 Feb 102226 ESMO Open
URL
Abstract Text The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with gastric cancer (GC), published in late 2022 and the updated ESMO Gastric Cancer Living Guideline published in July 2023, were adapted in August 2023, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with GC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with GC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), coordinated by ESMO and the Japanese Society of Medical Oncology (JSMO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different Asian regions represented by the 10 oncological societies. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with GC across the different regions of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices, molecular profiling and age and stage at presentation. Attention is drawn to the disparity in the drug approvals and reimbursement strategies, between the different regions of Asia.

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Molecular Profile Treatment Approach
Gene Name Source Synonyms Protein Domains Gene Description Gene Role
Therapy Name Drugs Efficacy Evidence Clinical Trials
Drug Name Trade Name Synonyms Drug Classes Drug Description
Gene Variant Impact Protein Effect Variant Description Associated with drug Resistance
Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
CD274 positive gastroesophageal junction adenocarcinoma sensitive Nivolumab Guideline Actionable Opdivo (nivolumab) in combination with platinum and fluoropyrimidine-based chemotherapy is included in the Pan-Asian Guidelines Adaptation (PAGA) as first-line therapy for patients with advanced untreated gastroesophageal junction cancer with a CD274 (PD-L1) expression of CPS >/=5 (PMID: 38458658; ESMO.org). detail... 38458658
CD274 positive esophageal cancer sensitive Nivolumab Guideline Actionable Opdivo (nivolumab) in combination with platinum and fluoropyrimidine-based chemotherapy is included in the Pan-Asian Guidelines Adaptation (PAGA) as first-line therapy for patients with advanced untreated esophageal cancer with a CD274 (PD-L1) expression of CPS >/=5 (PMID: 38458658; ESMO.org). 38458658 detail...
CD274 positive stomach cancer sensitive Nivolumab Guideline Actionable Opdivo (nivolumab) in combination with platinum and fluoropyrimidine-based chemotherapy is included in the Pan-Asian Guidelines Adaptation (PAGA) as first-line therapy for patients with advanced untreated gastric cancer with a CD274 (PD-L1) expression of CPS >/=5 (PMID: 38458658; ESMO.org). 38458658 detail...
MLH1 negative stomach cancer sensitive Pembrolizumab Guideline Actionable Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as second-line therapy for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) gastric cancer (PMID: 38458658; ESMO.org). 38458658 detail...
CD274 positive stomach cancer sensitive Pembrolizumab Guideline Actionable Keytruda (pembrolizumab) in combination with platinum and fluoropyrimidine-based chemotherapy is included in the Pan-Asian Guidelines Adaptation (PAGA) as first-line therapy for patients with ERBB2 (HER2)-negative, metastatic gastric cancer with CD274 (PD-L1) expression, especially for those with higher levels of tumor CD274 (PD-L1) expression (PMID: 38458658; ESMO.org). detail... 38458658
MSH2 negative stomach cancer sensitive Pembrolizumab Guideline Actionable Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as second-line therapy for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) gastric cancer (PMID: 38458658; ESMO.org). 38458658 detail...
PMS2 negative stomach cancer sensitive Pembrolizumab Guideline Actionable Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as second-line therapy for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) gastric cancer (PMID: 38458658; ESMO.org). detail... 38458658
CD274 positive gastroesophageal junction adenocarcinoma sensitive Pembrolizumab Guideline Actionable Keytruda (pembrolizumab) in combination with platinum and fluoropyrimidine-based chemotherapy is included in the Pan-Asian Guidelines Adaptation (PAGA) as first-line therapy for patients with ERBB2 (HER2)-negative, metastatic gastroesophageal junction cancer with CD274 (PD-L1) expression, especially for those with higher levels of tumor CD274 (PD-L1) expression (PMID: 38458658; ESMO.org). detail... 38458658
MSH6 negative stomach cancer sensitive Pembrolizumab Guideline Actionable Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) as second-line therapy for patients with mismatch repair deficient (dMMR, often defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) gastric cancer (PMID: 38458658; ESMO.org). detail... 38458658