Gastroesophageal, Pancreatic, and Hepatobiliary – Rapid Oral Abstract Session

This last daily highlight in GI cancer at ASCO 2025 is presented by Dr Andreas Domen (University Hospital Antwerp), who has selected two particularly interesting presentations from the rapid oral abstract session on GI cancer. 

The ESOPEC trial compared preoperative chemoradiotherapy using the CROSS regimen to perioperative fluorouracil-based treatment (FLOT scheme) for patients with advanced gastroesophageal adenocarcinoma. Last year, the trial reported that the FLOT group demonstrated significantly better OS and PFS compared to the preoperative chemoradiotherapy group. This year, the study presented additional data on recurrence patterns, revealing that the FLOT group also showed significantly better recurrence-free survival and distant metastasis-free survival. These findings further support the FLOT scheme as the more effective treatment approach for advanced gastroesophageal adenocarcinoma. 

The Keynote-016 trial, a multicenter Phase 2 study, investigated pembrolizumab in MSI-high or mismatch repair-deficient tumours, including advanced colorectal, endometrial, pancreatic, gastroesophageal cancers, and others. Pembrolizumab, a PD-1 checkpoint inhibitor, showed high efficacy in these tumours, and the study reported long-term follow-up results. After 10 years, the overall response rate was 58% across both colorectal and non-colorectal cancer types, which is notably high. Radiological progression at two years occurred in only two patients, and the 10-year OS was around 47%, a very impressive outcome. The study concludes that pembrolizumab offers durable remission for MSI-high or mismatch repair-deficient tumours and demonstrates tumour-agnostic efficacy of PD-1 inhibition in these patients.