Gastric / GEJ adenocarcinoma · line 1 · FOLFOX + Nivolumab

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

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

Line of therapy	1
Track	standard
Linked regimen	`REG-FOLFOX-NIVO`

ID	`IND-GASTRIC-METASTATIC-1L-PDL1-CHEMO-ICI`
Type	Indication
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Diseases	`DIS-GASTRIC`
Sources	`SRC-CHECKMATE-649-JANJIGIAN-2022` `SRC-ESMO-GASTRIC-2024` `SRC-NCCN-GASTRIC-2025`

Notes

Gastric metastatic 1L HER2-neg PD-L1 CPS ≥1 track. Indication threshold reconciled with RF-GASTRIC-PDL1-CPS-1-PLUS (CPS ≥1) and NCCN/ESMO 2024-2025 consensus (GI-2 B1 chunk gi2-cps-recon-nivo-dose-2026-05-04-2030). Algorithm ALGO-GASTRIC-METASTATIC-1L step 3 gates ICI add-on via the ≥1 RedFlag; magnitude-of-benefit difference between CPS ≥5 (HR 0.71) and CPS 1-4 (HR 0.78) per CheckMate-649 captured in expected_outcomes stratum fields and known_controversies.

Used By

Actionability

BMA-PDL1-CPS-GASTRIC - PD-L1 CPS is a continuous IHC score used as an eligibility threshold for ICI-containing r...

Algorithms

ALGO-GASTRIC-METASTATIC-1L - ALGO-GASTRIC-METASTATIC-1L

Red flag

RF-GASTRIC-PDL1-CPS-1-PLUS - Advanced/metastatic gastric or GE-junction adenocarcinoma with PD-L1 combined positive sc...