HER2-positive esophageal/GEJ adenocarcinoma scored by gastric criteria: trastuzumab + che...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`BMA-HER2-AMP-ESOPHAGEAL`
Type	Actionability
Status	reviewed 2026-04-27 \| pending_clinical_signoff \| actionability review required
Diseases	`DIS-ESOPHAGEAL`
Sources	`SRC-ESMO-ESOPHAGEAL-2024` `SRC-NCCN-ESOPHAGEAL-2025`

Actionability Facts

Biomarker	`BIO-HER2-SOLID`
Variant	amplification / overexpression — IHC 3+ or (IHC 2+ + ISH amplified) using gastric Hofmann 2008 criteria; ~10-30% of esophageal/GEJ adenocarcinoma
Disease	`DIS-ESOPHAGEAL`
ESCAT tier	IA
Recommended combinations	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)
Contraindicated monotherapy	trastuzumab monotherapy, anti-HER2 therapy in squamous-cell esophageal carcinoma
Evidence summary	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. Source-gap: SRC-TOGA-BANG-2010, SRC-KEYNOTE-811, SRC-DESTINY-GASTRIC01 not ingested.

Used By

No reverse references found in the YAML corpus.