Adénocarcinome oesophagien HER2 positif/GEJ noté par critères gastriques : trastuzumab + che...
Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.
| ID | BMA-HER2-AMP-ESOPHAGEAL |
|---|---|
| Type | Pertinence thérapeutique |
| État | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Maladies | DIS-ESOPHAGEAL |
| Sources | SRC-ESMO-ESOPHAGEAL-2024 SRC-NCCN-ESOPHAGEAL-2025 |
Faits relatifs à l ' action en justice
| Biomarqueur | BIO-HER2-SOLID |
|---|---|
| Variante | amplification/surexpression — IHC 3+ ou (IHC 2+ + ISH amplifié) en utilisant les critères de Hofmann gastrique 2008; ~10-30% d'adénocarcinome oesophagien/GEJ |
| Maladie | DIS-ESOPHAGEAL |
| Niveau ESCAT | IA |
| Combinaisons recommandées | trastuzumab + fluoropyrimidine + platinum (1L per SRC-NCCN-ESOPHAGEAL-2025, SRC-ESMO-ESOPHAGEAL-2024), pembrolizumab + trastuzumab + fluoropyrimidine + platinum (1L HER2+ PD-L1 CPS≥1 GEJ adenocarcinoma per SRC-NCCN-ESOPHAGEAL-2025), trastuzumab deruxtecan (2L+ per SRC-NCCN-ESOPHAGEAL-2025) |
| Contre-indiqué en monothérapie | trastuzumab en monothérapie, traitement anti-HER2 dans le carcinome oesophagien des cellules squameuses |
| Résumé des faits | HER2-positive esophageal/GEJ adenocarcinoma scored by gastric criteria: trastuzumab + chemotherapy is preferred 1L (cross-referenced from ToGA / KEYNOTE-811) per SRC-NCCN-ESOPHAGEAL-2025, SRC-ESMO-ESOPHAGEAL-2024. Pembrolizumab + trastuzumab + fluoropyrimidine/platinum is FDA-approved for HER2+ PD-L1 CPS≥1 metastatic GEJ adenocarcinoma (KEYNOTE-811). Trastuzumab deruxtecan is FDA-approved 2L+ for HER2-positive advanced gastric/GEJ adenocarcinoma (DESTINY-Gastric01 includes Siewert types). Squamous-cell esophageal carcinoma is HER2-negative as a rule and is not in scope for HER2-directed therapy. |
Notes
ESCAT IA / OncoKB Level 1. HER2 testing for adenocarcinoma histology only (not squamous). Heterogeneity high — ≥4 biopsies recommended. Bibliographic record SRC-DESTINY-GASTRIC01-SHITARA-2020 is available; SRC-TOGA-BANG-2010 and SRC-KEYNOTE-811 remain source gaps. Claim-level linkage requires clinical sign-off.
Utilisé par
No reverse references found in the YAML corpus.