Understanding Gastroesophageal Adenocarcinoma: What Pharmacists Should Know

Matthew Arango, PharmD, explains the basics of gastroesophageal adenocarcinoma (GEA), including its risk factors, typical patient profile, diagnostic process, and why cancers of the lower esophagus and stomach are treated as a single disease.

Matthew Arango, PharmD, discusses the importance and challenges of HER2 testing in gastroesophageal adenocarcinoma and how biomarker results influence early treatment decisions and patient counseling.

In this section, Matthew Arango, PharmD, outlines how treatment for HER2-overexpressed gastroesophageal adenocarcinoma (GEA) has traditionally been approached and what distinguishes the major HER2-targeted agents used or emerging in this space.

In this part of the discussion, Matthew Arango, PharmD, reviews what the DESTINY-Gastric studies have shown about trastuzumab deruxtecan (Enhertu; Daiichi Sankyo, AstraZeneca) in patients with progressive HER2-positive GEA, including response rates, survival benefits, and important safety considerations such as interstitial lung disease.

In this segment, Matthew Arango, PharmD, walks through the essential counseling points pharmacists emphasize when patients begin HER2-diredcted therapy, helping them recognize what side effects are expected versus symptoms that require urgent attention.

In this portion of the conversation, Matthew Arango, PharmD, discusses how pharmacists approach monitoring for cardiotoxicity when patients receive HER2-directed therapies, beginning with the baseline cardiac assessments needed before treatment starts.

In this segment, Matthew Arango, PharmD, highlights the key moments when pharmacists add the most value within a multidisciplinary GEA care team—from initial treatment planning to ongoing patient support. He discusses how pharmacists streamline prior authorization for HER2-targeted therapies by ensuring complete, timely documentation and leveraging strategies that minimize delays.

In this final portion of the conversation, Matthew Arango, PharmD, reflects on the core principles pharmacists should keep front-of-mind when managing HER2-positive GEA. He shares perspectives on how the pharmacist’s role is poised to expand as new HER2-targeted therapies, biomarkers, and clinical data reshape the treatment landscape.