In patients with locally advanced unresectable or metastatic gastric cancer who are HER2-negative, the choice of palliative systemic therapy at the third-line stage depends on prior treatment history and biomarker profile. Evidence-based options are available for this population.
Locally advanced unresectable or metastatic gastric cancer confirmed to be HER2-negative. In this population, HER2-directed therapy is not applicable, and treatment selection is guided by prior therapy exposure and other biomarkers, including PD-L1 status relevant at earlier lines.
Palliative third-line systemic therapy is recommended for this setting. Depending on prior treatment history, the approach may draw from immunotherapy or cytotoxic agent classes. Full regimen options, sequencing criteria, and eligibility details are in the complete protocol.
DOI: 10.5230/jgc.2025.25.e11
Palliative first-line systemic therapy with anti-PD-1 antibody combined with fluoropyrimidine/platinum-based chemotherapy is recommended in patients with HER2-negative and PD-L1-positive locally advanced unresectable or metastatic gastric cancer.
Palliative third-line systemic therapy is recommended in patients with locally advanced unresectable or metastatic gastric cancer.
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