OnCo

Small intestine cancer (small bowel adenocarcinoma): lines of therapy

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

LineAll comersMSI-H / dMMRpMMR / MSS
Early / localised1··
Locally advanced1··
Advanced, first line·11

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersLocalisedSegmental resection with en bloc lymphadenectomy; pancreatoduodenectomy for duodenal tumours not amenable to segmental resection.

Locally advanced

SubgroupSettingApproachProducts and trialsEvidence
All comersAdjuvant (stage III; selected stage II)Fluoropyrimidine with oxaliplatin (CAPOX or FOLFOX) for six months, extrapolated from colon cancer; BALLAD is the randomised test.82

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
MSI-H / dMMRAdvanced, MSI-high / dMMRPembrolizumab first line (tumour-agnostic approval; ZEBRA and KEYNOTE-158 cohorts).98
pMMR / MSSAdvanced, MSSCAPOX or FOLFOX first line; taxane- or irinotecan-based second line; HER2-directed therapy in trials; clinical trial enrolment encouraged.82

Sequence and caution pairings

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.