Canadian Consensus Recommendations for Predictive Biomarker Testing in Gastric and Gastroesophageal Junction Adenocarcinoma.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 9502503 Publication Model: Electronic Cited Medium: Internet ISSN: 1718-7729 (Electronic) Linking ISSN: 11980052 NLM ISO Abbreviation: Curr Oncol Subsets: MEDLINE

Publication: 2021- : Basel, Switzerland : MDPI
Original Publication: Toronto : Multimed, c1994-

Adenocarcinoma*/therapy ; Adenocarcinoma*/diagnosis ; Biomarkers, Tumor* ; Esophageal Neoplasms*/diagnosis ; Esophageal Neoplasms*/therapy ; Esophagogastric Junction*/pathology ; Stomach Neoplasms*/diagnosis ; Stomach Neoplasms*/therapy; Humans ; Canada ; Consensus

Gastric cancer is common globally and has a generally poor prognosis with a low 5-year survival rate. Targeted therapies and immunotherapies have improved the treatment landscape, providing more options for efficacious treatment. The use of these therapies requires predictive biomarker testing to identify patients who can benefit from their use. New therapies on the horizon, such as CLDN18.2 monoclonal antibody therapy, require laboratories to implement new biomarker tests. A multidisciplinary pan-Canadian expert working group was convened to develop guidance for pathologists and oncologists on the implementation of CLDN18.2 IHC testing for gastric and gastroesophageal junction (G/GEJ) adenocarcinoma in Canada, as well as general recommendations to optimize predictive biomarker testing in G/GEJ adenocarcinoma. The expert working group recommendations highlight the importance of reflex testing for HER2, MMR and/or MSI, CLDN18, and PD-L1 in all patients at first diagnosis of G/GEJ adenocarcinoma. Testing for NTRK fusions may also be included in reflex testing or requested by the treating clinician when third-line therapy is being considered. The expert working group also made recommendations for pre-analytic, analytic, and post-analytic considerations for predictive biomarker testing in G/GEJ adenocarcinoma. Implementation of these recommendations will provide medical oncologists with accurate, timely biomarker results to use for treatment decision-making.

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Keywords: CLDN18; CLDN18.2; HER2; IHC; MMR; PD-L1; gastric cancer; immunohistochemistry; immunotherapy; targeted therapy

0 (Biomarkers, Tumor)

Adenocarcinoma Of Esophagus

Date Created: 20241227 Date Completed: 20241227 Latest Revision: 20250104

20250114

PMC11674259

10.3390/curroncol31120572

39727695