GI Cancer Experts on Notable Updates Shared During the 2025 ASCO Annual Meeting

We spoke with the following investigators in the field of gastrointestinal (GI) cancer to get their perspective on the most significant updates in the space shared during the 2025 ASCO Annual Meeting:

Dirk Arnold, MD, PhD, the director of the Asklepios Tumorzentrum Hamburg and the head of the Department of Oncology, Hematology, and Palliative Care at AK Altona.

Kohei Shitara, MD, the director of the Department of Gastrointestinal Oncology at National Cancer Center Hospital East.

Yelena Y. Janjigian, MD, the chief of the Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center.

Ronan J. Kelly, MD, the chief of oncology, the W.W. Caruth, Jr. Chair in Immunology, and the founder and director of the Texas Cancer Interception Institute at Baylor Scott & White Health.

Vincent Picozzi, MD, a medical oncologist at Virginia Mason Franciscan Health.

During the meeting, there were several notable updates, including positive data with the addition of atezolizumab (Tecentriq) to chemotherapy as adjuvant treatment for patients with deficient mismatch repair colorectal cancer (CRC) in the phase 3 Alliance A021502; ATOMIC trial (NCT02912559), Arnold said. It was also impressive to see how the addition of targeted agents to chemotherapy improved outcomes for patients with CRC harboring BRAF V600 mutations, he added.

Shitara and Janjigian both highlighted findings from the phase 3 MATTERHORN study (NCT04592913), which evaluated durvalumab (Imfinzi) plus FLOT (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel) in patients with resectable gastric/gastroesophageal junction (GEJ) cancer. Findings from the study showed that patients who received the combination (n = 474) experienced a median event-free survival that was not reached (NR; 95% CI, 40.7-NR) vs 32.8 months (95% CI, 27.9-NR) among patients who received placebo plus FLOT (n = 474; HR, 0.71; 95% CI, 0.58-0.86; log-rank P < .001). These findings further cemented FLOT as the best systemic regimen for this patient population and it was encouraging to see investigators build on this efficacy with the addition of durvalumab, Janjigian said.

Data from the phase 3 DESTINY-Gastric04 trial (NCT04704934) firmly position fam-trastuzumab deruxtecan (T-DXd; Enhertu) as a standard-of-care option in the second line for patients with unresectable or metastatic HER2-positive gastric/GEJ adenocarcinoma. Findings from the study showed that patients who received T-DXd experienced a significant overall survival benefit compared with those treated with ramucirumab (Cyramza) plus paclitaxel (HR, 0.70; 95% CI, 0.55-0.90; P = .0044).

During the meeting, there were several presentations that examined artificial intelligence–supported approaches, which was notable, Picozzi said. Pancreatic cancer research is also attracting a lot of attention from investigators across the world, he added.