Gastric & gastro-oesophageal junction cancer: guideline history
3 dated versions from 2021 to 2024 listing 6 changes. Pick two versions to see what changed between them; the timeline below shows every version with the event it is anchored to.
- AddedMetastatic, HER2-negative, PD-L1 CPS 5 or above, first lineNivolumab plus chemotherapy recommended for CPS 5 or above [I, A; ESMO-MCBS 4].
- AddedMetastatic, HER2-positive, first linePembrolizumab added to trastuzumab and chemotherapy for PD-L1-positive HER2-positive disease (KEYNOTE-811) [I, B].
- AddedMetastatic, HER2-negative, first linePembrolizumab with chemotherapy for PD-L1 CPS 1 or above.
- AddedMetastatic, HER2-negative, Claudin 18.2-positive, first lineZolbetuximab with chemotherapy for tumours with Claudin 18.2 staining in 75% or more of cells.
Timeline
Anchored to: FDA approvals of trastuzumab deruxtecan for HER2-positive gastric cancer (January 2021, DESTINY-Gastric01) and nivolumab with chemotherapy (April 2021, CheckMate 649)
- addedMetastatic, HER2-positive, second line: Trastuzumab deruxtecan after trastuzumab-based therapy.
- addedMetastatic, HER2-negative, first line: Nivolumab with fluoropyrimidine-platinum chemotherapy, preferred for PD-L1 CPS 5 or above.
Anchored to: Annals of Oncology publication, 2022
- addedMetastatic, HER2-negative, PD-L1 CPS 5 or above, first line: Nivolumab plus chemotherapy recommended for CPS 5 or above [I, A; ESMO-MCBS 4].
- addedMetastatic, HER2-positive, first line: Pembrolizumab added to trastuzumab and chemotherapy for PD-L1-positive HER2-positive disease (KEYNOTE-811) [I, B].
Anchored to: FDA approvals of pembrolizumab with chemotherapy for HER2-negative disease (November 2023, KEYNOTE-859) and zolbetuximab (October 2024, SPOTLIGHT and GLOW)
- addedMetastatic, HER2-negative, first line: Pembrolizumab with chemotherapy for PD-L1 CPS 1 or above.
- addedMetastatic, HER2-negative, Claudin 18.2-positive, first line: Zolbetuximab with chemotherapy for tumours with Claudin 18.2 staining in 75% or more of cells.
Where the bodies stand today
| Setting and intervention | NCCN | ESMO | NICE | ASCO | Verdict |
|---|---|---|---|---|---|
Gastric & gastro-oesophageal junction cancer · Metastatic, HER2-negative, first line Nivolumab with fluoropyrimidine-platinum chemotherapy (CheckMate 649) | Recommended Category 1 (CPS 5 or above); 2B (CPS 1-4) 2021-04 | Restricted I, A; ESMO-MCBS 4 (CPS 5 or above) 2022-10 | Restricted TA857 2023-02 | · | Bodies disagree |
Other cancers
Each entry is anchored to a dated public event and links to the guideline body’s page for the disease; NCCN “Summary of changes” pages sit behind a free login and are not reproduced. Version labels say “update” where the NCCN version number has not been verified. Corrections are welcome via the repository.