Rapid oral abstract session: GI – gastro-oesophageal, pancreatic and hepatobiliary

In this highlight video from ASCO 2026, Prof Dr Hans Prenen, medical oncologist at Antwerp University Hospital, highlighted three studies presented during the rapid oral abstract session on gastro-oesophageal, pancreatic and hepatobiliary cancer.

The phase III HERIZON-GEA-01 trial evaluated zanidatamab, a bispecific HER2-targeted antibody, plus chemotherapy with or without tislelizumab versus trastuzumab plus chemotherapy as first-line treatment for HER2-positive unresectable, locally advanced, recurrent or metastatic gastro-oesophageal adenocarcinoma.^1,2 At ASCO 2026, efficacy was presented according to PD-L1 status, assessed by both TAP score and CPS. In the intention-to-treat population, zanidatamab plus tislelizumab and chemotherapy significantly improved both progression-free survival (PFS) and overall survival (OS) compared with trastuzumab plus chemotherapy, with median PFS of 12.4 versus 8.1 months and median OS of 26.4 versus 19.2 months. Importantly, the benefit was consistent in both PD-L1-positive and PD-L1-negative disease, regardless of the scoring method used. These data support zanidatamab plus tislelizumab and chemotherapy as a new first-line standard of care in HER2-positive metastatic gastro-oesophageal adenocarcinoma, irrespective of PD-L1 status.

A phase IIa study evaluated atebimetinib, a novel MEK1/2 inhibitor, in combination with modified gemcitabine and nab-paclitaxel as first-line treatment for metastatic or locally advanced pancreatic ductal adenocarcinoma.³ In 55 patients, the combination showed promising activity, with an objective response rate of 36%, disease control rate of 82%, median progression-free survival of 8.3 months and median overall survival of 17.3 months. Safety appeared manageable, with grade ≥3 anaemia (16%) and neutropenia (18%) mainly attributed to chemotherapy, and few severe MEK inhibitor class-effect toxicities. The results support further evaluation in the ongoing global randomised phase III MAPKeeper 301 trial.

The phase III FIGHT-302 trial investigated pemigatinib versus gemcitabine plus cisplatin as first-line treatment for unresectable locally advanced or metastatic cholangiocarcinoma with FGFR2 rearrangements.^4,5 The study was closed early because of slow accrual, but still demonstrated a significant improvement in PFS with pemigatinib, with median PFS of 8.34 months versus 6.80 months for chemotherapy. Pemigatinib also produced higher objective response rate (47.0% vs 15.5%) and disease control rate (89.2% vs 67.9%) compared with chemotherapy, with a median duration of response of 14.2 months. Overall survival was not improved with pemigatinib versus chemotherapy (median OS: 24.4 vs 25.0 monts).