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This is Part 3 of Evolving Treatment Paradigms for Neuroendocrine Tumors, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Daniel Halperin, Jess Maxwell, and Virginia Corbett discuss the use of radioligand therapy for advanced neuroendocrine tumors (NETs). The patient is a 72-year-old man who was incidentally found to have small hypervascular liver masses on screening computer tomography. Abdominal imaging revealed a 1.8-cm pancreatic tail lesion and disseminated subcentimeter liver metastases occupying 20% of the liver parenchyma. A biopsy confirmed a grade 1 NET with Ki-67 1%. In the conversation that follows, the faculty discuss whether they would proceed with surgery or opt for a somatostatin analog, treatment options after disease progression, sequencing considerations when using peptide receptor radionuclide therapy, and more.
This is Part 2 of Evolving Treatment Paradigms for Neuroendocrine Tumors, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Daniel Halperin, Jess Maxwell, and Virginia Corbett discuss the treatment of well-differentiated grade 3 small bowel neuroendocrine tumor (NET). The patient is a 55-year-old man who presents with unexplained weight loss and mild, vague abdominal discomfort over the past 18 months. A computed tomography reveals hepatic metastases in segments VII and VIII and a mesenteric mass along the ileocolic artery with edematous bowel wall in the associated territory, without obstruction. Liver biopsy reveals well-differentiated NET with Ki-67 30%. In the conversation that follows, the faculty discuss how to weigh surgical decisions in patients with well-differentiated vs poorly differentiated grade 3 NETs, whether the radioligand lutetium-177 dotatate would be an option for this patient post resection, and alternatives to radioactive therapy, such as cabozantinib.
This is Part 1 of Evolving Treatment Paradigms for Neuroendocrine Tumors, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Daniel Halperin, Jess Maxwell, and Virginia Corbett discuss the treatment pancreatic neuroendocrine tumor (NET). The patient is a 40-year-old woman who presents with right flank pain, nausea, and vomiting. She is found to have hypercalcemia secondary to hyperparathyroidism, and a contrast-enhanced computed tomography reveals multifocal hypervascular lesions in the pancreas. Genetic testing confirms multiple endocrine neoplasia, type 1 (MEN1). In the conversation that follows, the faculty discuss the role of genetic testing in patients with multifocal pancreatic NETs, when surgical resection is appropriate, and potential treatment options for this patient—including temozolomide, everolimus, and radioligand therapy.
In the United States, approximately 55% of patients with resected gallbladder cancer undergo oncologic surgery without additional systemic treatment. However, as gallbladder cancer progresses to T3 (locally or regionally advanced) or T4 (distant metastasis) disease, the tumor frequently infiltrates ...
Patients with gastrointestinal cancer treated with fluoropyrimidine chemotherapy benefit from an almost eightfold reduction in the risk of all-cause mortality, despite a slight increase in the risk for cardiovascular toxicity, according to recent findings published by Abiodun et al in JACC:...
In a Japanese phase III trial (RINDBeRG) reported in the Journal of Clinical Oncology, Sakai et al assessed whether the addition of ramucirumab to irinotecan would improve overall survival in third- or later-line treatment of patients with advanced or recurrent gastric or gastroesophageal cancer...
A recent study published in the Annals of Internal Medicine1 estimated incidence rates of appendiceal adenocarcinoma across birth cohorts in the United States. Andreana N. Holowatyj, PhD, MSCI, of Vanderbilt-Ingram Cancer Center, Nashville, and colleagues observed a sharp increase in incidence...
Yelena Y. Janjigian, MD, of Memorial Sloan Kettering Cancer Center, presents event-free survival data from the phase III MATTERHORN trial of the PD-L1 inhibitor durvalumab plus FLOT (fluorouracil, leucovorin, oxaliplatin and docetaxel chemotherapy) in patients with resectable gastric or gastroesophageal junction (GEJ) cancer (LBA5).
In a French phase III trial (PRODIGE 51-FFCD-GASTFOX) reported in The Lancet Oncology, Zaanan et al found that a modified FLOT (fluorouracil, oxaliplatin, and docetaxel) regimen known as TFOX (docetaxel, folinic acid, oxaliplatin, and fluorouracil) improved outcomes vs FOLFOX (folinic acid,...
In patients with aggressive gastroenteropancreatic neuroendocrine tumors, first-line treatment with the mTOR inhibitor everolimus and the somatostatin analog lanreotide more than doubled the median progression-free survival for patients vs everolimus alone, in the phase III JCOG1901 (STARTER-NET)...
Cancer-related studies were among the nearly 6,000 abstracts presented at Digestive Disease Week® (DDW) 2025, including research on artificial intelligence (AI) in patient communication, polyp detection, and colonoscopy prep. Use of AI in Patient Communication AI outperformed physicians in...
Anal cancer has been steadily increasing in the United States, with the biggest jumps among older women, especially White and Hispanic women, a new study presented at Digestive Disease Week 2025 (Abstract 76) found. According to the investigators, this shift challenges assumptions about high-risk...
Using next-generation DNA sequencing, researchers have identified four specific genes whose mutations are linked to the development and progression of lethal stomach cancers. This could potentially enable practitioners to offer targeted treatments that would spare many patients from unnecessarily...
In a Dutch noninferiority phase III trial (SANO) reported in The Lancet Oncology, van der Wilk et al found that active surveillance was noninferior to standard surgery in terms of 2-year overall survival among patients with esophageal cancer who had a clinical complete response after neoadjuvant...
The U.S. Food and Drug Administration (FDA) has granted traditional approval to the PD-L1 inhibitor pembrolizumab (Keytruda) with trastuzumab, fluoropyrimidine-, and platinum-containing chemotherapy for the first-line treatment of adults with locally advanced unresectable or metastatic...
The 2025 ASCO Gastrointestinal Cancers Symposium once again delivered a slate of high-impact studies spanning esophageal, gastric, hepatocellular, pancreatic, biliary tract, and colorectal malignancies. Experts in the field offered fresh perspectives on evolving standards of care, and investigators ...
A study evaluating the genetic landscape of candidate primary resistance alterations relevant to KRAS targeting in KRAS G12C–mutant colorectal cancers and pancreatic ductal adenocarcinomas (PDAC) has found that putative resistance alterations are prevalent in these cancers. The finding may explain...
Researchers may have uncovered insights into the role of bacteria in the development of gastric cancer, according to a novel study published by Giddings et al in Helicobacter. The findings could pave the way for a more effective precancer treatment option. Background Gastric cancer is the fourth...
A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance on the use of radiation therapy to treat adult patients with primary squamous cell carcinoma of the anal canal and anal margin. The guideline, ASTRO’s first for anal cancer, is published in...
As reported in The Lancet Oncology by Zhang et al, final outcomes of the Chinese phase III RESOLVE trial showed improved overall survival with adjuvant S-1 and oxaliplatin (SOX) and perioperative SOX vs adjuvant capecitabine/oxaliplatin (CapOx) in patients with locally advanced gastric or...
Investigators may have uncovered notable pharmacokinetic differences between male and female patients in at least 14 anticancer drugs, according to a recent study published by Delahousse et al in ESMO Open. Background Many cancer drugs have a narrow therapeutic window. As a result, slight...
A recent study found that a combination of the mTOR inhibitor everolimus and the hormone-blocking drug lanreotide extended progression-free survival compared with everolimus alone for people with some types of neuroendocrine tumors in the pancreas or gastrointestinal tract. The research will be...
The risk of having children who experience preterm birth and low birth weight—but not birth defects—may be increased among male adolescents and young adults with cancer, according to a recent study published by Murphy et al in the Journal of the National Cancer Institute. Background Prior research...
In a Chinese phase I trial (KYM901) reported in The Lancet Oncology, Ruan et al found that CMG901—a first-in-class claudin 18.2–targeting antibody-drug conjugate—had manageable toxicity and activity in patients with advanced gastric or gastroesophageal junction (GEJ) cancer. CMG901 comprises a...
New research may expand on existing evidence that a healthy diet may protect against gastrointestinal cancers and improve disease outcomes, according to a recent study published by Abebe et al in the European Journal of Nutrition. Background Gastrointestinal cancers including esophageal, gastric,...
As reported in the Journal of Clinical Oncology by Pavlakis et al, the phase III INTEGRATE IIa study showed improved overall survival with regorafenib plus best supportive care vs placebo vs best supportive care in patients with refractory advanced gastric/esophagogastric junction cancer. Study...
Total neoadjuvant therapy (TNT) followed by rectal surgery is the standard of care in proficient mismatch repair (pMMR) locally advanced rectal cancer, but studies are finding that patients with clinical complete response may often avoid surgery and be followed “nonoperatively.” In the first...
Based on a descriptive, U.S. population–based cohort study reported in JAMA Network Open by Alvarez et al, over the past 2 decades, the incidence of gastrointestinal stromal tumors in major organ sites has increased among several patient populations. The findings may assist in directing future...
In a long-term follow-up of a French phase III trial (BFR14) reported in The Lancet Oncology, Jean-Yves Blay, MD, and colleagues found that discontinuation of imatinib in patients with advanced gastrointestinal stromal tumors (GIST) with at least stable disease was associated with markedly poorer...
Targeting lactate with the epilepsy drug stiripentol may reverse chemotherapy resistance in patients with gastric cancer, according to a recent study published by Chen et al in Nature. Background Chemotherapy attacks cancer cells by damaging their DNA. The cancer cells then try to rapidly repair...
As reported in The Lancet by Simron Singh, MD, MPH, FRCPC, and colleagues, primary results of the international, multicenter, randomized phase III NETTER-2 study have shown significantly improved progression-free survival with the addition of the radioligand lutetium-177 dotatate (Lu-177 dotatate)...
In the phase II RELATIVITY-060 study, results of which were reported in the Journal of Clinical Oncology, Susanna Hegewisch-Becker, MD, PhD, and colleagues found that the addition of the LAG-3–blocking antibody relatlimab to first-line nivolumab plus chemotherapy did not improve the objective...
The U.S. Food and Drug Administration (FDA) has approved trastuzumab-strf (Hercessi), a biosimilar to trastuzumab (Herceptin), for the treatment of HER2-overexpressing breast cancer and gastric or gastroesophageal junction adenocarcinoma. Trastuzumab-strf is indicated for adjuvant treatment of...
In a French noncomparative phase II trial (PRODIGE 59-FFCD 1707-DURIGAST) reported in JAMA Oncology, Tougeron et al found limited activity of FOLFIRI (leucovorin, fluorouracil, and irinotecan) plus durvalumab or durvalumab/tremelimumab in the second-line treatment of advanced...
The PD-1/CTLA-4 bispecific antibody cadonilimab plus chemotherapy improved progression-free and overall survival in patients with untreated, HER2-negative, locally advanced or metastatic gastric or gastroesophageal junction (GEJ) cancer—including those with PD-L1–low tumors—compared with...
In an Indian single-center phase III trial (D-TORCH) reported in the Journal of Clinical Oncology, Santhosh et al found that topical diclofenac gel significantly reduced the risk of capecitabine-associated hand-foot syndrome vs placebo gel in patients with breast or gastrointestinal cancer who were ...
As reported in the Journal of Clinical Oncology by Yelena Y. Janjigian, MD, and colleagues, 3-year follow-up of the phase III CheckMate 649 trial has shown the continued benefit of the addition of nivolumab to chemotherapy in the first-line treatment of advanced gastric, gastroesophageal junction,...
The combination of fruquintinib and paclitaxel is a potential new second-line treatment for patients with advanced gastric or gastroesophageal junction cancer, according to data presented during the ASCO Plenary Series: February 2024 Session (Abstract 438780). Results of the phase III FRUTIGA...
Ian Chau, MD, of The Royal Marsden Hospital, discusses reportedly the first study to evaluate the real-world effectiveness of nivolumab as a first-line treatment of advanced gastric, gastroesophageal junction, or esophageal adenocarcinoma. The combination therapy improved overall survival compared with chemotherapy alone. Dr. Chau presents the 18-month follow-up results (Abstract 295).
Yasunobu Ishizuka, MD, of Japan’s Aichi Cancer Center, discusses study results showing that scheduling infusions of nivolumab monotherapy before mid-afternoon for patients with metastatic gastric cancer may alter treatment efficacy. Several studies have suggested that circadian rhythm is essential in immune system function, including anticancer immunity (Abstract 268).
Lorraine A. Chantrill, PhD, MBBS, of Australia’s Wollongong Hospital, New South Wales, discusses phase II findings on the combination of nab-paclitaxel plus carboplatin as a first-line treatment for patients with gastrointestinal neuroendocrine carcinomas. According to Dr. Chantrill, this regimen appears to be active in these tumors and warrants further evaluation in a phase III trial (Abstract 589).
Anant Ramaswamy, DM, of Tata Memorial Centre, discusses phase III results of a study that added docetaxel to a doublet regimen of fluorouracil or capecitabine and oxaliplatin, which did not improve overall survival in patients with advanced gastroesophageal junction and gastric cancers. Continuing chemotherapy beyond 6 months also did not appear to improve survival in this population (Abstract LBA248).
Subgroup analyses of the randomized double-blind phase III MATTERHORN trial continue to show the benefit of adding perioperative durvalumab to standard chemotherapy in patients with locally advanced, resectable gastric or gastroesophageal junction cancer. Detailed findings on pathologic complete...
As reported in The Lancet Oncology by Kohei Shitara, MD, and colleagues, interim analyses of the phase III KEYNOTE-585 trial have shown that the addition of perioperative pembrolizumab to chemotherapy improved pathologic complete response, but did not significantly improve event-free survival, in...
ASCO discussant Elizabeth Smyth, MD, a consultant medical oncologist at Oxford University Hospitals National Health Service Foundation Trust in the United Kingdom, commented on the EDGE-Gastric trial. This regimen, which evaluated dual checkpoint blockade with next-generation agents, aims to...
Initial findings from the global phase II EDGE-Gastric trial indicate the potential for two novel immune checkpoint inhibitors to improve outcomes in advanced gastroesophageal adenocarcinoma. The findings were reported at the November 2023 ASCO Plenary Session by Yelena Y. Janjigian, MD, Chief of...
Early findings from the phase II EDGE-Gastric trial indicate the potential for two novel agents to make a difference in advanced gastroesophageal adenocarcinoma, according to findings reported at the ASCO Plenary Series: November 2023 Session by Yelena Y. Janjigian, MD, Chief of the...
On November 7, the U.S. Food and Drug Administration (FDA) revised the existing indication of pembrolizumab (Keytruda) in combination with trastuzumab, fluoropyrimidine, and platinum-containing chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic...
A first-in-class, claudin 18.2 (CLDN18.2)-targeted antibody-drug conjugate may be a new treatment option for patients with advanced gastric/gastroesophageal junction (GEJ) cancers, according to data presented by Xu et al during the ASCO Plenary Series: November 2023 Session (Abstract 434420)....
In interim analyses from the phase III KEYNOTE-811 trial reported in The Lancet, Yelena Y. Janjigian, MD, and colleagues found that the addition of pembrolizumab to trastuzumab and chemotherapy in first-line treatment of patients with locally advanced or metastatic HER2-positive...