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Cancers & treatments·Sequencing

PD-L1-high gastric cancer: lines of therapy

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4 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersPD-L1
Early / localised1·
Advanced, first line·2
Second line1·

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersResectable stage II to IIIPerioperative FLOT with durvalumab (MATTERHORN), given irrespective of PD-L1 score.
MATTERHORNDurvalumabFLOT (5-FU, leucovorin, oxaliplatin, docetaxel)
90

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
PD-L1Advanced, first line, CPS 5 or aboveNivolumab with FOLFOX or CAPOX (CheckMate 649) or pembrolizumab with platinum-fluoropyrimidine chemotherapy (KEYNOTE-859).
CheckMate 649KEYNOTE-859NivolumabPembrolizumabFOLFOX (5-FU, leucovorin, oxaliplatin)CAPOX (capecitabine, oxaliplatin)PD-L1Combined positive score (CPS)
98
PD-L1Advanced, first line, CPS 1 to 4PD-1 antibody with chemotherapy is permitted in the United States and offered with a smaller expected gain; chemotherapy alone or zolbetuximab where claudin 18.2 is positive.
NivolumabPembrolizumabZolbetuximabCombined positive score (CPS)
98

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersSecond lineRamucirumab with paclitaxel (RAINBOW); no established role for continued PD-1 blockade.
RAINBOWRamucirumabPaclitaxel / nab-paclitaxel
94

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.