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    Association details:
    Biomarker:MSI-H/dMMR
    Cancer:Gastroesophageal Junction Adenocarcinoma
    Drug:Keytruda (pembrolizumab) (PD1 inhibitor)
    Direction:Sensitive
    Evidence:
    Evidence Level:
    Sensitive: A2 - Guideline
    New
    Source:
    NCCN
    Published date:
    08/29/2023
    Excerpt:
    Esophageal and Esophagogastric Junction Cancers: Adenocarcinoma…Preferred Regimens…MSI-H/dMMR tumors (independent of PD-L1 status)…Pembrolizumab...Fluoropyrimidine (fluorouracil or capecitabine), oxaliplatin, and pembrolizumab…
    Secondary therapy:
    5-fluorouracil + oxaliplatin; capecitabine + oxaliplatin
    Evidence Level:
    Sensitive: B - Late Trials
    Source:
    JAMA Oncol
    Title:

    Assessment of Pembrolizumab Therapy for the Treatment of Microsatellite Instability-High Gastric or Gastroesophageal Junction Cancer Among Patients in the KEYNOTE-059, KEYNOTE-061, and KEYNOTE-062 Clinical Trials

    Published date:
    04/01/2021
    Excerpt:
    Pembrolizumab monotherapy in KEYNOTE-059, pembrolizumab monotherapy or chemotherapy (paclitaxel) in KEYNOTE-061, and pembrolizumab monotherapy, pembrolizumab plus chemotherapy (cisplatin and 5-fluorouracil or capecitabine)...In KEYNOTE-062, the ORR was 57.1% for pembrolizumab , 64.7% for pembrolizumab plus chemotherapy, and 36.8% for chemotherapy....MSI-H status may be a biomarker for pembrolizumab therapy among patients with advanced G/GEJ cancer...
    Secondary therapy:
    XP; CF; paclitaxel
    DOI:
    0.1001/jamaoncol.2021.0275
    Trial ID:
    KEYNOTE-062; KEYNOTE-059; KEYNOTE-061
    Evidence Level:
    Sensitive: C1 - Off-label
      (Approved for Small Intestinal Carcinoma)
    Title:

    European Commission Approves Merck’s KEYTRUDA® (pembrolizumab) for Patients With Microsatellite Instability-High (MSI-H) or Deficient Mismatch Repair (dMMR) Tumors in Five Different Types of Cancer

    Excerpt:
    Merck...announced that the European Commission has approved KEYTRUDA, Merck’s anti-PD-1 therapy, as monotherapy for the treatment of microsatellite instability-high (MSI-H) or deficient mismatch repair (dMMR) tumors in adults with...unresectable or metastatic gastric, small intestine or biliary cancer, who have disease progression on or following at least one prior therapy.
    Evidence Level:
    Sensitive: C2 – Inclusion Criteria
    Source:
    clinicaltrials.gov
    Title:

    A Study to Evaluate the Safety and the Activity of S095029 as Part of Combination Therapy in Advanced Gastroesophageal Junction/Gastric Cancers.

    Excerpt:
    ...- Participants' tumor must have an MSI-H or dMMR status according to institutional guidelines and/or according to the College of American Pathologists, determined at any time prior to enrolment....
    Trial ID:
    Keynote E70
    Evidence Level:
    Sensitive: C2 – Inclusion Criteria
    Source:
    clinicaltrials.gov
    Title:

    Study of Pembrolizumab in Subjects With Advanced Gastric or Gastroesophageal Junction Adenocarcinoma Who Progressed After First-Line Therapy With Platinum and Fluoropyrimidine: Integration of Molecular Subtypes Through Integrative Genomic Analysis

    Excerpt:
    ...(Only Cohort B) confirmed as MSI-H via the PCR or IHC staining by institutional standard....
    Trial ID:
    NCT02589496
    More C2 evidence