Pembrolizumab Boosts Response Rates in HER2+ Gastroesophageal Cancer

Pembrolizumab Boosts Response Rates in HER2+ Gastroesophageal Cancer

The recently published phase II trial demonstrates significant benefits of incorporating pembrolizumab into first-line treatment regimens. The study, published on February 17, 2025, revealed an impressive objective response rate of 69% and a median progression-free survival of 11.9 months in patients with advanced HER2-positive gastroesophageal cancer. This combination approach, which sequentially added pembrolizumab to traditional 5FU/platinum chemotherapy plus trastuzumab, shows particular promise for patients with dual HER2-positive and PD-L1 positive status.The trial’s comprehensive biomarker analysis revealed fascinating insights into how the treatment works. Researchers observed that trastuzumab initially triggers natural killer cell infiltration in HER2-positive tumor beds, while increasing Fc receptor expression in macrophages. This remodeling of the tumor environment is further enhanced when pembrolizumab is introduced, particularly in PD-L1 positive samples.

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These findings represent a significant step forward in the treatment of HER2-positive gastroesophageal cancer. The study’s results suggest that carefully sequenced combination therapy could become a new standard approach for specific patient subgroups. The trial’s insights into tumor heterogeneity and immune cell features provide valuable guidance for patient selection, potentially helping clinicians identify those most likely to benefit from this treatment approach. However, the presence of TGF-β signaling in HER2-negative tumor regions was associated with non-response, indicating the need for additional strategies in certain cases.


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