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CME: Initial and later line approaches to the systemic treatment of unresectable and metastatic gastric and gastroesophageal junction (GEJ) cancer


Activity Description / Statement of Need:

In this online, self-learning activity:

Gastric cancer (GC) accounts for over 26,000 new cases and 11,000 related deaths in the U.S. annually, and while malignancies of the esophagus and gastroesophageal junction (GEJC) are associated with 19,000 and 15,000, respectively. GEJ tumors clinically more often resemble gastric than esophageal cancers, and GEJ cancers are often included in studies of GC. Adenocarcinomas represent more than 95% of gastric cancers and around 75% of esophageal cancers in the US. Staging of GC & GEJC depends on the tumor’s histopathology, location, and degree of spread, and 36% of patients in the U.S. are diagnosed in the advanced stages of the disease because the signs and symptoms are often initially clinically silent for most of the disease course, and missed opportunities for identification are not uncommon. The prognosis of GC & GEJC is poor: the 5-year overall survival (OS) rate of GC is 32%, with the five-year OS rate of patients with advanced disease is six percent.

Target Audience:

HCPs including: Medical oncologists; physicians assistants, nurse practitioners, and pharmacists specializing in oncology; and any other clinicians involved or interested in the treatment of GC & GEJC.

Commercial Support Disclosure: This program is supported by an educational grant from Astellas.

This activity is free of charge.

Release Date: February 01, 2023 -- Expiration Date: February 01, 2024

Faculty: Elizabeta Popa, MD


Faculty introduction and disclosures

Introductory content and review of unresectable and metastatic GC & GEJC

·       Statistics and prognosis

·       Patient evaluation

Treatment of unresectable and metastatic GC and GEJC

·       Patient and disease-related factors driving therapeutic decision-making for GC and GEJC, including the role of biomarkers 

·       Treatment goals

·       Present pharmacotherapy, clinical trial findings, and guideline updates, including the roles of: 

o   Squamous cell vs. adenocarcinoma

o   PD-L1 expressing

o   Deficient mismatch repair

o   HER2 overexpression

o   Chemotherapy

·       Emerging targets – FGFR2b, PARP, CLDN18.2 

·       Special considerations, including treatment of the elderly and frail 

·       Patient case(s) 

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall factors impacting therapeutic decision-making in the treatment of unresectable and metastatic GC & GEJC, including biomarker and optimal sequencing considerations.
  • Describe present and emerging treatment options for unresectable and metastatic GC & GEJC; their mechanisms of action; place or anticipated place in therapy; and risk-benefit profiles.
  • Formulate a treatment plan for a patient with unresectable and metastatic GC or GEJC.


ACCME Activity #202381967


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosure of Faculty: Elizabeta C. Popa MD, Assistant Professor of Clinical Medicine, Weill Cornell Medicine, has no relevant financial disclosures.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty WILL discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Astellas.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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