The National Comprehensive Cancer Network (NCCN) recently released treatment guideline updates for esophageal and esophagogastric junction cancers, involving a systemic therapy in the second-line setting.
For the third time in 2017, the NCCN has made changes to their treatment recommendations for patients with gastrointestinal cancers. As a minor edit, the guidelines now suggest microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) solid tumor testing if metastatic diseases is documented or suspected.
The major change to the guideline includes a new systemic therapy option for unresectable locally advanced, recurrent or metastatic disease and where local therapy is not indicated. As a second-line therapy option in this case, the NCCN recommends pembrolizumab for MSI-H or dMMR tumors.
Pembrolizumab should be administered intravenously (200 mg) on day 1, and cycled every 21 days, according to the regimen and dosing schedule.—Zachary Bessette