MatchMedi
한국어

Options mapped

Gastric / gastro-oesophageal junction cancer: options by country

Sourced options by country plus visit-prep questions for Gastric / gastro-oesophageal junction cancer. Each line links to its regulator, HTA, or guideline source. This page maps options; it does not recommend or rank them.

Options mappedSolid tumorLast checked June 2026

What this page does

Maps options by country

It maps sourced options by country alongside diagnosis wording, stage, test results, specialists, and trial-search terms.

What it does not do

Does not choose treatment

It does not rank treatments, recommend a choice, or decide clinical fit.

Where it comes from

Built on trusted sources

Every option links to a trusted regulator, HTA, or guideline source, and the list grows as new sources pass verification.

Information to gather before the next visit

  • Is the tumor HER2-positive on the local test used for treatment selection?
  • Is PD-L1 CPS greater than or equal to 1 on an FDA-authorized assay?
  • Is this truly first-line treatment for locally advanced unresectable or metastatic disease?
  • Is the tumor confirmed HER2-negative?

Trial-search terms to discuss

Gastric / gastro-oesophageal junction cancer clinical trial

Options by country

Treatments by country

Regulatory and access status by country, from official sources. It shows what exists and where — not a recommendation.

United States

  • fam-trastuzumab deruxtecan-nxki (Enhertu)[1]ApprovedHER2-positive defined as IHC 3+ or IHC 2+/ISH positive; after a prior trastuzumab-based regimen in locally advanced or metastatic disease. · The label directs HER2-based patient selection and says to reassess HER2 status if feasible after prior trastuzumab-based therapy and before treatment with ENHERTU. This cycle did not assess institutional infusion access or payer coverage.
  • nivolumab and hyaluronidase-nvhy (Opdivo Qvantig) monotherapy or with fluoropyrimidine/platinum chemotherapy, depending on indication[2]Approvedresidual pathologic disease after neoadjuvant chemoradiotherapy for adjuvant cell; PD-L1 >= 1 for first-line ESCC and gastric/GEJ/esophageal adenocarcinoma cells in the fetched Qvantig label; adjuvant after neoadjuvant chemoradiotherapy and complete resection with residual disease; first-line unresectable advanced/metastatic ESCC; advanced/metastatic gastric-GEJ-esophageal adenocarcinoma. · This label source is for subcutaneous Opdivo Qvantig and includes formulation-specific limitations, including not being indicated with ipilimumab for unresectable advanced/metastatic ESCC. Intravenous Opdivo label should be checked separately where formulation matters. Confidence/conflicts: medium-high; current label supports subcutaneous Opdivo Qvantig indications, but IV Opdivo should be checked separately for formulation-specific use. No conflict identified.
  • pembrolizumab (Keytruda) plus fluoropyrimidine- and platinum-containing chemotherapy[3]FDA-approvedHER2-negative; PD-L1 CPS greater than or equal to 1 by FDA-authorized test; first-line treatment of locally advanced unresectable or metastatic disease. · The label is limited to HER2-negative disease with PD-L1 CPS greater than or equal to 1 by an FDA-authorized test. This cycle did not compare it against non-pembrolizumab first-line U.S. options or payer coverage.
  • pembrolizumab (Keytruda) plus platinum- and fluoropyrimidine-based chemotherapy[3]FDA-approvedPD-L1 CPS >= 1 for combination therapy; GEJ tumours with epicenter 1 to 5 cm above the GEJ; locally advanced or metastatic disease not amenable to surgery or definitive chemoradiation; combination chemotherapy setting. · Requires PD-L1 CPS >= 1 by an FDA-authorized test for the combination indication. This label wording should be checked against the current FDA-approved prescribing information before patient-facing reuse. Confidence/conflicts: high for current label wording; no conflict identified.
  • pembrolizumab (Keytruda) plus trastuzumab plus fluoropyrimidine- and platinum-containing chemotherapy[3]FDA-approvedHER2-positive; PD-L1 CPS greater than or equal to 1 by FDA-authorized test; first-line treatment of locally advanced unresectable or metastatic disease. · The label requires both HER2-positive disease and PD-L1 CPS greater than or equal to 1 by an FDA-authorized test. This cycle did not assess payer coverage, infusion-center access, or regimen fit for a specific chemotherapy backbone.
  • pembrolizumab (Keytruda) single agent[3]FDA-approvedsquamous cell histology; PD-L1 CPS >= 10; after one or more prior lines of systemic therapy. · Applies to squamous cell histology and PD-L1 CPS >= 10. It is not the same as the first-line chemotherapy-combination indication. Confidence/conflicts: high for current label wording; no conflict identified.
  • ramucirumab (Cyramza) as a single agent or with paclitaxel[4]Approvedno biomarker gate in the U.S. label; after disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy. · The label does not require a biomarker but does require prior fluoropyrimidine- or platinum-containing chemotherapy exposure with progression on or after that treatment. This cycle did not separate monotherapy versus paclitaxel-combination selection logic beyond the label language.
  • zolbetuximab-clzb (Vyloy) plus fluoropyrimidine- and platinum-containing chemotherapy[5]FDA-approvedHER2-negative; Claudin-18.2-positive defined in the label as at least 75% of tumor cells with moderate to strong membranous CLDN18 staining by an FDA-approved test; first-line treatment of locally advanced unresectable or metastatic disease. · Patient selection is narrower than "CLDN18.2-positive" shorthand because the label specifies the at-least-75%-of-tumor-cells moderate-to-strong membranous staining threshold. The label also highlights severe nausea, vomiting, and infusion/hypersensitivity risks.

European Union

  • nivolumab (Opdivo) monotherapy[6]EMA authorisedresidual pathologic disease after prior neoadjuvant chemoradiotherapy; adjuvant treatment after prior neoadjuvant chemoradiotherapy with residual pathologic disease. · EMA central authorisation does not establish national reimbursement or local access. The source wording is not limited to a specific histology in the cited indication line. Confidence/conflicts: high for EMA central indication; local reimbursement unverified. No conflict identified.
  • nivolumab (Opdivo) plus fluoropyrimidine- and platinum-based combination chemotherapy[6]EMA authorisedHER2-negative; PD-L1 CPS >= 5; first-line advanced or metastatic adenocarcinoma. · This is an adenocarcinoma indication and should not be conflated with oesophageal squamous cell carcinoma indications. EMA authorisation does not determine Germany/France reimbursement. Confidence/conflicts: high for EMA central indication; local reimbursement unverified. No conflict identified.
  • pembrolizumab (Keytruda) monotherapy[7]EMA authorisedMSI-H or dMMR; unresectable or metastatic gastric cancer after progression on or following at least one prior therapy. · This tissue-agnostic-like non-colorectal MSI-H/dMMR indication is specifically listed for gastric, small intestine, or biliary cancer. Confirm biomarker status and prior-therapy context. Confidence/conflicts: high for EMA indication scope; no conflict identified.
  • pembrolizumab (Keytruda) plus fluoropyrimidine and platinum-containing chemotherapy[7]EMA authorisedHER2-negative; PD-L1 CPS >= 1; first-line locally advanced unresectable or metastatic disease. · Requires HER2-negative disease and PD-L1 CPS >= 1 as stated by EMA. Country-level reimbursement and formulary access are separate from EMA central authorisation. Confidence/conflicts: high for EMA indication scope; no conflict identified.
  • pembrolizumab (Keytruda) plus trastuzumab, fluoropyrimidine, and platinum-containing chemotherapy[7]EMA authorisedHER2-positive; PD-L1 CPS >= 1; first-line locally advanced unresectable or metastatic disease. · Requires HER2-positive disease and PD-L1 CPS >= 1 as stated by EMA. EMA central authorisation does not establish reimbursement or access in a particular member state. Confidence/conflicts: high for EMA indication scope; no conflict identified.
  • ramucirumab (Cyramza) plus paclitaxel; ramucirumab monotherapy when paclitaxel combination is not appropriate[8]EMA authoriseddisease progression after prior platinum and fluoropyrimidine chemotherapy for combination therapy; after prior platinum or fluoropyrimidine chemotherapy when paclitaxel is not appropriate for monotherapy. · EMA central indication does not guarantee reimbursement in each member state. This entry does not imply paclitaxel suitability or individual candidacy. Confidence/conflicts: high for EMA indication scope; no conflict identified.
  • zolbetuximab (Vyloy) plus fluoropyrimidine- and platinum-containing chemotherapy[9]EMA authorisedHER2-negative; Claudin (CLDN) 18.2-positive; first-line locally advanced unresectable or metastatic disease. · EMA notes Vyloy is under additional monitoring and is an orphan medicine. Requires HER2-negative and CLDN18.2-positive tumour status. Confidence/conflicts: high for EMA indication scope; no conflict identified.

United Kingdom

  • nivolumab (Opdivo)[10]Approvedresidual disease after previous neoadjuvant chemoradiotherapy; adjuvant treatment after complete resection and previous neoadjuvant chemoradiotherapy with residual disease. · NICE notes treatment choice depends on factors including histology, tumour size/location, patient preference, and treatment suitability; commercial arrangement applies. Confidence/conflicts: high for NICE recommendation; devolved/private access outside NICE context not verified. No conflict identified.
  • nivolumab (Opdivo) plus platinum- and fluoropyrimidine-based chemotherapy[11]ApprovedHER2-negative; PD-L1 CPS >= 5; untreated advanced or metastatic adenocarcinoma. · This cell applies to adenocarcinoma and should not be generalized to squamous-cell disease. NICE describes usual chemotherapy backbones as XELOX or FOLFOX in its rationale. Confidence/conflicts: high for NICE recommendation; devolved/private access outside NICE context not verified. No conflict identified.
  • nivolumab (Opdivo) with platinum- and fluoropyrimidine-based chemotherapy[11]ApprovedPD-L1 CPS >= 5; HER2-negative; untreated advanced or metastatic disease. · NICE states usual treatment is palliative chemotherapy and that nivolumab is recommended under the commercial arrangement. This entry includes gastric/GEJ because NICE TA857 covers gastric, GEJ, and oesophageal adenocarcinoma. Confidence/conflicts: high for NICE recommendation scope; no conflict identified.
  • oesophago-gastric clinical nurse specialist access; psychosocial support; specialist dietetic support; enteral/parenteral nutrition after radical surgery; rapid MDT access for recurrence symptoms[12]NICE recommendedacross radical treatment, palliative care, postoperative nutrition, and symptom-triggered follow-up. · These are supportive-care service and follow-up recommendations; they do not replace oncology treatment planning or imply routine imaging surveillance solely to detect recurrence. Confidence/conflicts: high for NICE guideline wording; local service availability not verified. No conflict identified.
  • pembrolizumab (Keytruda) with platinum- and fluoropyrimidine-based chemotherapy[13]ApprovedPD-L1 CPS >= 1; HER2-negative; untreated locally advanced unresectable or metastatic disease. · NICE recommendation is conditional on the commercial arrangement and applies within the marketing authorisation. Biomarker requirements are HER2-negative and PD-L1 CPS >= 1. Confidence/conflicts: high for NICE recommendation scope; no conflict identified.
  • perioperative chemotherapy for radical gastric surgery; palliative combination chemotherapy; palliative stenting/radiotherapy/local tumour treatment; nutritional and dietitian support[12]NICE recommendedradical gastric surgery context; untreated advanced palliative setting; obstruction and nutrition-support contexts. · NICE frames palliative chemotherapy around performance status and comorbidities, and obstruction interventions around fitness, prognosis, and disease extent. This is not individualized eligibility. Confidence/conflicts: high for NICE NG83 recommendation scope; no conflict identified.
  • perioperative chemotherapy or chemoradiotherapy before surgery; palliative combination chemotherapy with fluoropyrimidine/platinum doublet or fluoropyrimidine/platinum/epirubicin triplet options[12]NICE recommendedHER2 testing recommended for advanced oesophago-gastric adenocarcinoma; preoperative/perioperative localised adenocarcinoma; untreated advanced oesophago-gastric cancer. · Advanced palliative chemotherapy recommendation is performance-status and comorbidity dependent. HER2 testing is recommended for advanced oesophago-gastric adenocarcinoma, but this finding does not imply HER2-targeted eligibility. Confidence/conflicts: high for NICE guideline wording; regimen choice and fitness not inferred. No conflict identified.
  • self-expanding stents; radiotherapy; local tumour treatment; best supportive care[12]NICE recommendedpalliative management / luminal obstruction; non-metastatic disease not suitable for surgery when high-dose radiotherapy field is not feasible. · NICE says not to routinely offer external beam radiotherapy after stenting, except to consider it for prolonged post-interventional bleeding or known bleeding disorder. Choice depends on symptoms, nutrition, performance status, prognosis, and MDT judgement. Confidence/conflicts: high for NICE guideline wording; individual symptom-management suitability not inferred. No conflict identified.
  • trastuzumab with cisplatin and capecitabine or fluorouracil[12]NICE recommendedHER2-positive; untreated HER2-positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction per the linked NICE appraisal. · NICE NG83 also recommends HER2 testing for advanced oesophago-gastric adenocarcinoma. This cell does not include pembrolizumab-trastuzumab, which NICE TA983 separately does not recommend for routine NHS use. Confidence/conflicts: high for NICE NG83 recommendation; pembrolizumab-trastuzumab is separately not recommended by NICE TA983 and is noted as a caveat.
  • trifluridine-tipiracil (Lonsurf)[14]Approvedafter two or more treatment regimens. · NICE states standard treatment for most people after two or more treatments is best supportive care and the recommendation depends on the commercial arrangement. Confidence/conflicts: high for NICE recommendation scope; no conflict identified.

Japan

  • nivolumab (Opdivo) with other antineoplastic agents including fluoropyrimidine/platinum chemotherapy[15]PMDA-approved (Japan)HER2-negative; PD-L1 expression should be considered per PMDA discussion; previously untreated unresectable, advanced or recurrent gastric cancer; HER2-negative population emphasized in PMDA's clinical-positioning discussion. · PMDA states Japanese original text takes precedence over English translation. PMDA also says it is difficult to conclude favorable risk-benefit in CPS <5 and that addition of nivolumab should be determined carefully taking PD-L1 expression into account. Confidence/conflicts: medium-high; PMDA English translation supports approval context, but Japanese original controls and PD-L1 subgroup caution is explicit. No conflict identified. Availability/reimbursement outside the approving regulator not established.
  • pembrolizumab (Keytruda) monotherapy[16]PMDA-approved (Japan)MSI-High; advanced or recurrent MSI-High solid tumours after cancer chemotherapy and refractory/intolerant to standard treatments. · This is an inference from PMDA's tumour-agnostic solid-tumour indication to gastric cancer as a solid tumour; the source does not name gastric cancer in the indication. PMDA required post-marketing surveillance for MSI-High solid tumours except colorectal cancer. Japanese original takes precedence over English translation. Confidence/conflicts: medium; PMDA verifies MSI-High solid-tumour approval, but gastric applicability is inferred from the solid-tumour category and should be checked against the current Japanese label. No conflict identified. Availability/reimbursement outside the approving regulator not established.
  • trastuzumab deruxtecan (Enhertu)[17]PMDA-approved (Japan)HER2-positive; unresectable advanced or recurrent HER2-positive gastric cancer after at least two chemotherapy regimens including trastuzumab. · PMDA noted adverse events requiring particular attention, and this entry does not provide dosing or eligibility. Japanese original label should be checked for current wording before patient-facing reuse. Confidence/conflicts: high for PMDA review-report indication context; no conflict identified. Availability/reimbursement outside the approving regulator not established.
  • zolbetuximab (Vyloy) in combination with other antineoplastic agents[18]PMDA-approved (Japan)CLDN18.2-positive; HER2-negative in pivotal efficacy discussion; unresectable advanced or recurrent gastric cancer; efficacy discussion specifies no prior chemotherapy for the CLDN18.2-positive/HER2-negative population. · PMDA required a risk management plan and further investigation of nausea/vomiting through post-marketing surveillance. CLDN18.2 positivity should be confirmed by adequately experienced pathologists or qualified laboratories per PMDA discussion. Confidence/conflicts: high for PMDA approval-review scope; no conflict identified. Availability/reimbursement outside the approving regulator not established.

Korea

  • zolbetuximab (Vyloy)[19]MFDS-approved (Korea)CLDN18.2-positive; HER2-negative inferred from global Vyloy indication context; Astellas page provides approval location/date but not full Korea label wording in the fetched content. · Company medical-information source intended for U.S. healthcare professionals; product labeling may vary by country. MFDS primary label remains a follow-up gap before patient-facing reuse. Confidence/conflicts: medium; approval date is company-sourced with MFDS citation, but MFDS page fetch timed out. No conflict identified. Availability/reimbursement outside the approving regulator not established.

China

Thailand

  • zolbetuximab (Vyloy)[19]FDA-approvedCLDN18.2-positive; HER2-negative inferred from global Vyloy indication context; Astellas page provides approval location/date but not full Thai label wording in the fetched content. · Company medical-information source intended for U.S. healthcare professionals; product labeling may vary between countries. Thai FDA primary label remains a follow-up gap before patient-facing reuse. Confidence/conflicts: medium; approval date is company-sourced with Thai FDA citation, but Thai FDA primary label was not fetched. No conflict identified. Availability/reimbursement outside the approving regulator not established.

Sources

  1. DailyMed / National Library of Medicine — official U.S. prescribing information / label repository · official U.S. prescribing information / label repository
  2. DailyMed / U.S. National Library of Medicine — official drug label · official drug label
  3. DailyMed / National Library of Medicine — official U.S. prescribing information / label repository · official U.S. prescribing information / label repository
  4. DailyMed / National Library of Medicine — official U.S. prescribing information / label repository · official U.S. prescribing information / label repository
  5. DailyMed / National Library of Medicine — official U.S. prescribing information / label repository · official U.S. prescribing information / label repository
  6. European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
  7. European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
  8. European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
  9. European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
  10. National Institute for Health and Care Excellence (NICE) — national HTA/guideline recommendation · national HTA/guideline recommendation
  11. National Institute for Health and Care Excellence (NICE) — national HTA/guideline recommendation · national HTA/guideline recommendation
  12. National Institute for Health and Care Excellence (NICE) — national guideline · national guideline
  13. National Institute for Health and Care Excellence (NICE) — technology appraisal guidance · technology appraisal guidance
  14. National Institute for Health and Care Excellence (NICE) — technology appraisal guidance · technology appraisal guidance
  15. Pharmaceuticals and Medical Devices Agency (PMDA) — regulator review report PDF / English translation · regulator review report PDF / English translation
  16. Pharmaceuticals and Medical Devices Agency (PMDA) — regulator review report PDF / English translation · regulator review report PDF / English translation
  17. Pharmaceuticals and Medical Devices Agency (PMDA) — regulator review report PDF / English translation · regulator review report PDF / English translation
  18. Pharmaceuticals and Medical Devices Agency (PMDA) — regulator review report PDF / English translation · regulator review report PDF / English translation
  19. Astellas Medical Information — manufacturer medical-information page citing regulator product information · manufacturer medical-information page citing regulator product information
  20. China National Medical Products Administration (NMPA) / CCFDIE — regulator approval notice · regulator approval notice

This is official regulatory and access status only — not medical advice, not a recommendation, and not a statement about eligibility. Whether any option fits depends on your situation and your oncology team. Status changes over time; confirm the current position with the linked source. Last checked 2026-06-12.

Beyond approved care

In clinical trials & emerging options

Options that are not — or not yet — an approved standard where you live: studies, clinical trials, off-label use, and early evidence that your own oncologist may not raise. Each is labeled by how strong the evidence is. A listing here is information to research and discuss with your team; it does not mean a treatment is proven, safe for you, or available today.

In clinical trials

A clinical-trial listing or early report shows an option is being studied — not that it works, that it is safe for any one person, or that a site is enrolling today. Whether any of these fits is a conversation for your oncology team and the trial team. Last checked 2026-06-12.