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NCCN Issues Guideline Update for Esophageal, Esophagogastric Junction Cancers


The National Comprehensive Cancer Network (NCCN) recently released treatment guideline updates for esophageal and esophagogastric junction cancers, involving a systemic therapy in the second-line setting.

For the third time in 2017, the NCCN has made changes to their treatment recommendations for patients with gastrointestinal cancers. As a minor edit, the guidelines now suggest microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) solid tumor testing if metastatic diseases is documented or suspected.

The major change to the guideline includes a new systemic therapy option for unresectable locally advanced, recurrent or metastatic disease and where local therapy is not indicated. As a second-line therapy option in this case, the NCCN recommends pembrolizumab for MSI-H or dMMR tumors.


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Pembrolizumab should be administered intravenously (200 mg) on day 1, and cycled every 21 days, according to the regimen and dosing schedule.—Zachary Bessette