#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ 27/31 #TumorBoardTuesday #EsophagogastricCancer #OncTwitter Mini tweetorial 13 👨🏽‍🏫 Givastomig 🐭 ➡️ induces T-cell activation in a dose- and CLDN18.2 expression-dependent manner. ➡️ Exerts bystander tumor killing (hits nearby CLDN18.2 negative tumor cells) ➡️ Givastomig + nivo +

#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ 28/31 #TumorBoardTuesday #EsophagogastricCancer #OncTwitter Mini tweetorial 14 👨🏽‍🏫 Are we good at testing for CLDN18.2? 🔬 Coati et al examined 523 primary gastric and GEJ carcinomas and 135 matched and synchronous nodal metastasis. ➡️ High CLDN18.2 expression was present 29.4%

Nicole Baranda Balmaceda, MD #TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ Tell me more...what is behind this response? Synergy? More CLDN18.2 expressed in metastatic cells in the brain? anti CLDN18.2 agent crosses BBB. 😭I don't know, it's late, I regret the concert tickets I didn't get at 1 am...I am just tossing things out here. #TumorBoardTuesday

#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ 29/31 #TumorBoardTuesday #EsophagogastricCancer #OncTwitter Poll: What percentage of any CLDN18.2 staining is found in esophagogastric cancer?

Hannah 💜 Nicole Baranda Balmaceda, MD #TumorBoardTuesday Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ Hard to say especially since brain metastases are rare in gastroesophageal cancers. But it's intriguing to see that with chemo alone, the brain mets did not response but with the addition of both PD-1 and CLDN18.2 inhibition, we are seeing BBB penetrance.

#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ gastriccancerbiomarkers.com/?utm_medium=cp…

Sunnie Kim, MD Nicole Baranda Balmaceda, MD #TumorBoardTuesday Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ That's amazing! Thank you for sharing this.

Nicole Baranda Balmaceda, MD #TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ #TumorBoardTuesday Isn't there a CAR-T and an engineered T cell receptor in trials against CLDN18.2 as well? Exciting to see more IO options potentially coming!

#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ 30/31 #TumorBoardTuesday #EsophagogastricCancer #OncTwitter Mini tweetorial 15 👨🏽‍🏫 Given different mechanisms of action, therapeutic efficacy may differ depending on degree of expression. For instance, ADCs may have the potential to be more effective at lower levels compared to

#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ 31/31 #TumorBoardTuesday #EsophagogastricCancer #OncTwitter Other mechanisms to target CLDN18.2 are underway! Thanks for listening! nature.com/articles/s4157…

#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ #PostTest Q1️⃣ #TumorBoardTuesday 👉🏽#CME Eval 🔗 integrityce.com/TBTeval24 👉🏽ALL CME🔗 integrityce.com/TBT2024 🤔CLDN18.2 with IHC 2/3+, ≥ 75% staining is found in what 📷 of gastroesophageal cancers❓ Shitara K, et al. Gastric Cancer. 2024 Sep;27(5):1058-1068.

Nicole Baranda Balmaceda, MD #TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ #TumorBoardTuesday So many trials underway in this space - enroll in these trials so we can see which drug(s) work best to help our patients‼️

#TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ #PostTest Q2️⃣ #TumorBoardTuesday 👉🏽 Free CME 🔗 integrityce.com/TBT2024 🧐 Which of the following would you select for a 67-year-old 🧑‍💼 diagnosed with HER2-negative (IHC 1+), PD-L1 CPS 2, CLDN18.2+ (IHC 2+) positive GEJ adenocarcinoma metastasized to the 📷❓ Shitara K, et al.

Mike Pishvaian Nicole Baranda Balmaceda, MD #TumorBoardTuesday Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ 💯

Mike Pishvaian Nicole Baranda Balmaceda, MD #TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ We need more open in the community, please 😃

Johnathan Ebben MD, PhD Nicole Baranda Balmaceda, MD #TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ #TumorBoardTuesday There are several - with really exciting early data....but it is SOOOO hard getting a slot for a patient

Sunnie Kim, MD Johnathan Ebben MD, PhD Nicole Baranda Balmaceda, MD #TumorBoardTuesday Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Exciting times ahead for cancer treatment! Let's make sure these guidelines pave the way for better patient outcomes.

OncoDaily Nicole Baranda Balmaceda, MD Sunnie Kim, MD #TumorBoardTuesday CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Looking forward to the discussion on CLDN18.2 in gastric cancer! Its role in treatment is fascinating and I'm excited to hear from the experts.

Nicole Baranda Balmaceda, MD #TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ I'd choose immunotherapy first, considering the patient's PD-L1 CPS 2 and CLDN18.2 2+ 90%. Would love to hear others' opinions on this!

Nicole Baranda Balmaceda, MD #TumorBoardTuesday Sunnie Kim, MD Integrity CE, LLC Kelsey Klute Raghav Sundar CU Cancer Center CU Anschutz Hematology/Oncology Fellowship Mark Lewis, MD, FASCO pamela kunz Kohei shitara Yelena Y. Janjigian MD Reetu Mukherji, MD ILSON David Sam Klempner Dr. Özlem TÜRECİ Exciting updates on the FOLFOX + Nivolumab + Givastomig trial! Congrats on the improvement in brain mets!