A 58-year-old man with metastatic gastric adenocarcinoma is found to have strong HER2/neu overexpression on immunohistochemistry. Which targeted agent, validated in the ToGA trial, improves survival when added to cisplatin and fluoropyrimidine chemotherapy?
- A Trastuzumab ✓
- B Ramucirumab
- C Bevacizumab
- D Pertuzumab
Correct answer: A. Trastuzumab
Explanation
The ToGA trial showed that adding trastuzumab, a monoclonal antibody against HER2, to cisplatin plus a fluoropyrimidine improved median survival in HER2 positive advanced gastric cancer, establishing it as standard first line therapy. Bevacizumab failed to improve survival in gastric cancer trials, ramucirumab is a second line option after progression, and pertuzumab did not add benefit beyond trastuzumab in this setting.
Reference: Schwartz's Principles of Surgery, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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