ESMO Gastrointestinal Oncology最新文献

{"title":"Highlights in oesophagogastric cancers from ESMO GI cancers congress 2025","authors":"A. Petrillo , F. Pietrantonio , I. Ben-Aharon","doi":"10.1016/j.esmogo.2025.100260","DOIUrl":"10.1016/j.esmogo.2025.100260","url":null,"abstract":"","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcome of patients with fibrolamellar hepatocellular carcinoma: an analysis of a large population using real-world data","authors":"F. Lo Prinzi ,&nbsp;S. Camera ,&nbsp;S. Foti ,&nbsp;M. Persano ,&nbsp;C.M. Gullotta ,&nbsp;F. Rossari ,&nbsp;F. Vitiello ,&nbsp;L. Passeri ,&nbsp;F. Michele ,&nbsp;A. Casadei-Gardini ,&nbsp;M. Rimini","doi":"10.1016/j.esmogo.2025.100272","DOIUrl":"10.1016/j.esmogo.2025.100272","url":null,"abstract":"<div><h3>Background</h3><div>Fibrolamellar carcinoma (FLC) is a rare subtype of hepatocellular carcinoma (HCC), accounting for ∼1%-9% of all HCC cases. The limited literature and lack of studies on FLC present significant challenges.</div></div><div><h3>Patients and methods</h3><div>We conducted a retrospective analysis using TriNetX data to evaluate patients’ characteristics and outcome in terms of overall survival (OS), among patients with FLC. Additionally, we conducted further analysis to evaluate differences in terms of patient characteristics and outcome between FLC and HCC; specifically, we compared patients with FLC and HCC who underwent any type of treatment, patients with FLC and HCC in the early stage who underwent surgery and patients with FLC and HCC with advanced disease treated in first-line therapy. Also, the same analyses were carried out after propensity score matching. The primary endpoints were features of patients and OS of FLC, and HCC versus FLC, particularly regarding systemic therapy and surgical interventions.</div></div><div><h3>Results</h3><div>In the FLC group, 87 patients were analyzed, with a median OS (mOS) of 56.1 months. Comparing HCC and FLC, 211 523 HCC patients and 87 FLC patients were included, showing no significant mOS difference [mOS 46.9 months versus 76.5 months, hazard ratio (HR) 1.21, <em>P</em> = 0.27], revealing significant differences in mean age (<em>P</em> &lt; 0.0001) and racial distribution (<em>P</em> &lt; 0.03). After propensity scoring, significant difference in α-fetoprotein (AFP) (<em>P</em> = 0.003) was discovered. In surgical cases, 116 276 HCC patients and 51 FLC patients had similar mOS (84.6 months versus 78.4 months, HR 0.94, <em>P</em> = 0.77), with significant differences in mean age (<em>P</em> &lt; 0.001), racial distribution (<em>P</em> = 0.0002), and body mass index (BMI) (<em>P</em> = 0.04). The propensity score revealed a significant difference in aspartate aminotransferase value (<em>P</em> = 0.04). In first-line treatments, 6090 HCC patients and 22 FLC patients showed no statistical difference in mOS (8.1 months versus 26.0 months, HR 1.44, <em>P</em> = 0.13), but differences were found in gender distribution (<em>P</em> = 0.0003), mean age (<em>P</em> &lt; 0.001), albumin levels (<em>P</em> = 0.01), and AFP values (<em>P</em> = 0.02). After propensity score matching, the analysis confirmed significant differences in AFP (<em>P</em> = 0.04) and total bilirubin value (<em>P</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>The current analysis showed no statistically significant differences in OS between patients with HCC and those with FLC at any stage, regardless of whether they received surgical or medical treatment. Significant statistical features were highlighted between the groups.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100272"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regorafenib and metronomic capecitabine, cyclophosphamide, and aspirin in refractory metastatic colorectal cancer: results from the REPROGRAM-01 single-arm phase II trial","authors":"A. El Kaddissi ,&nbsp;A. Vienot ,&nbsp;J.-D. Fumet ,&nbsp;A. Meurisse ,&nbsp;T. Nguyen ,&nbsp;E. Klajer ,&nbsp;A. Bouard ,&nbsp;L. Spehner ,&nbsp;F. Fein ,&nbsp;M. Stouvenot ,&nbsp;E. Dochy ,&nbsp;M. Rebucci-Peixoto ,&nbsp;H. Almotlak ,&nbsp;J. Henriquez ,&nbsp;Z. Selmani ,&nbsp;D. Vernerey ,&nbsp;E. Hervouet ,&nbsp;A. Folletet ,&nbsp;S. Kim ,&nbsp;F. Ghiringhelli ,&nbsp;C. Borg","doi":"10.1016/j.esmogo.2025.100270","DOIUrl":"10.1016/j.esmogo.2025.100270","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of chemotherapy-resistant metastatic colorectal cancers (mCRCs) is still an unmet medical need. Combining regorafenib, an antiangiogenic multikinase inhibitor with metronomic chemotherapy and aspirin may enhance efficacy to circumvent the tumor microenvironment and offer better clinical outcomes. REPROGRAM-01 was a signal-seeking phase II study assessing the efficacy and safety of multimodal metronomic chemotherapy combined with regorafenib (NCT04534218).</div></div><div><h3>Patients and methods</h3><div>mCRC patients involved were previously exposed to conventional chemotherapies, bevacizumab, anti-epidermal growth factor receptor (anti-EGFR) if <em>RAS</em> wild type, and pembrolizumab if deficient mismatch repair disease. Regorafenib (starting dose 80 mg/day orally with weekly escalation, per 40 mg increment, to 160 mg/day) was combined with multimodal metronomic chemotherapy including capecitabine (625 mg/m² twice daily continuously) and cyclophosphamide (50 mg daily) for 6 months plus aspirin (75 mg once daily). The primary endpoint was the objective response rate (ORR). Secondary endpoints were overall survival (OS), progression-free survival (PFS), safety, and evaluation of exploratory biomarkers.</div></div><div><h3>Results</h3><div>Forty-eight patients were included. No unexpected serious adverse event was reported and 10 patients discontinued regorafenib for toxicity. The most common grade 3 and 4 toxicities involved palmoplantar erythrodysesthesia (14.6%), diarrhea (6.3%), hypertension (4.2%), and lymphopenia (4.2%). The best ORR was 4.2% [95% confidence interval (CI) 0.8% to 12.5%]. The trial was negative on the primary endpoint aiming to achieve an ORR of 15%, compared with 4% for null hypothesis. Median PFS and OS were 4.7 months (95% CI 3.7-5.9 months) and 9.5 months (95% CI 7.2-14.9 months), respectively. The PFS rates at 6 months and 12 months were 32.5% and 6.5%, respectively. A decrease of NPY methylated circulating tumor DNA &gt;50% occurred in 16 out of the 26 assessable patients, leading to a median PFS of 5.5 months (95% CI 3.7-9.5 months) versus 3.6 (95% CI 1.8-9.6 months). A median PFS of 7.2 months (95% CI 3.7-11.6 months) was achieved in patients with decreasing angiopoietin-2 (ANG2) levels compared with 3.9 months (95% CI 1.3-19.4 months) in ANG2 nonresponding patients.</div></div><div><h3>Conclusions</h3><div>According to the REPROGRAM-01 study, combining multimodal metronomic chemotherapy with regorafenib would double the number of patients who could benefit from regorafenib treatment without increasing toxicities.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lecithinized superoxide dismutase prevents oxaliplatin-induced peripheral neuropathy: a double-blind, placebo-controlled, randomized phase II study","authors":"T. Yamada ,&nbsp;T. Hata ,&nbsp;A. Ishiguro ,&nbsp;Y. Munemoto ,&nbsp;K. Kataoka ,&nbsp;A. Hirose ,&nbsp;A. Matsuda ,&nbsp;H. Sonoda ,&nbsp;H. Tanji ,&nbsp;K. Ogihara ,&nbsp;T. Ishikawa ,&nbsp;N. Ishizuka ,&nbsp;K. Yamazaki ,&nbsp;T. Kato ,&nbsp;K. Yamaguchi ,&nbsp;T. Mizushima","doi":"10.1016/j.esmogo.2025.100269","DOIUrl":"10.1016/j.esmogo.2025.100269","url":null,"abstract":"<div><h3>Background</h3><div>Oxaliplatin-based adjuvant chemotherapy improves recurrence-free survival in stage II/III colorectal cancer (CRC) patients. However, oxaliplatin treatment is frequently limited by chemotherapy-induced peripheral neuropathy (CIPN). Oxidative stress is implicated in CIPN pathogenesis. Lecithinized superoxide dismutase (PC-SOD) is a long-circulating antioxidant enzyme that has demonstrated favorable pharmacokinetics and safety in prior studies. This study aimed to evaluate the efficacy of PC-SOD in preventing oxaliplatin-induced CIPN.</div></div><div><h3>Materials and methods</h3><div>In this double-blind, placebo-controlled, randomized trial, patients with stage II/III CRC scheduled to receive 12 cycles of mFOLFOX6 were randomly assigned to receive intravenous PC-SOD (80 mg) or placebo before each oxaliplatin dose. The primary endpoint was the number of cycles until National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) grade ≥2 CIPN occurred. Secondary endpoints included time to Neurotoxicity Criteria of DEBIOPHARM (DEB-NTC) grade ≥2 CIPN. <em>Post hoc</em> exploratory analyses evaluated time to NCI-CTCAE grade ≥1 CIPN and infusion-related reaction (IRR).</div></div><div><h3>Results</h3><div>Ninety patients were enrolled (PC-SOD: <em>n</em> = 43; placebo: <em>n</em> = 47). The primary endpoint was not met [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.44-1.78, <em>P</em> = 0.72]. However, the PC-SOD group experienced delayed onset of DEB-NTC grade ≥2 CIPN (HR 0.73, 95% CI 0.48-1.12, <em>P</em> = 0.08) and NCI-CTCAE grade ≥1 CIPN (HR 0.62, 95% CI 0.40-0.96, <em>P</em> = 0.01, <em>post hoc</em>). The incidence of IRRs (<em>post hoc</em>) was notably lower in the PC-SOD group (7.0%) compared with placebo (23.4%).</div></div><div><h3>Conclusions</h3><div>This trial did not meet its primary endpoint, maybe due to underpowered sample size. PC-SOD showed a potential to delay the onset of oxaliplatin-induced CIPN and reduced IRR. A confirmatory study on a large scale and with adequate statistical power is needed.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100269"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic solid pseudopapillary neoplasms of the pancreas: current treatment status and exploration of endocrine therapy","authors":"M. Yue ,&nbsp;Y. Mao ,&nbsp;F. Wang ,&nbsp;Q. Yang ,&nbsp;X. Yu ,&nbsp;H. Tang ,&nbsp;Y. Lan ,&nbsp;L. Tan ,&nbsp;W. Wang ,&nbsp;S. Li ,&nbsp;F. Wang","doi":"10.1016/j.esmogo.2025.100266","DOIUrl":"10.1016/j.esmogo.2025.100266","url":null,"abstract":"<div><h3>Background</h3><div>Solid pseudopapillary neoplasm (SPN) of the pancreas is rare and indolent. However, some patients with malignant potential develop metastasis. We aimed to analyze current treatment status and explore optimized clinical management of metastatic SPNs.</div></div><div><h3>Patients and methods</h3><div>Clinical data of metastatic SPN patients were collected from literature and two hospitals. Gene set enrichment analysis of RNA expression profiles of tumor tissues versus normal pancreatic tissues from the GEO database was carried out to explore functionally enriched pathways. Fresh tumor tissues from 10 SPN patients were cultured and <em>in vitro</em> hormonal agent sensitivity testing was conducted. Six patients received endocrine therapy with tamoxifen and megestrol acetate.</div></div><div><h3>Results</h3><div>A total of 115 metastatic SPN patients were included. Eighty-four patients underwent local treatment, including surgery, interventional therapy, and radiotherapy. Cytoreductive therapy significantly improved overall survival (<em>P</em> &lt; 0.05, hazard ratio 0.11, 95% confidence interval 0.02-0.68). Thirty-six patients received chemotherapy and only one achieved partial response. Concurrent enrichment of the Wnt signaling pathway and progesterone receptor signaling pathway in SPNs was revealed. Drug sensitivity testing showed inhibition rates (IRs) of 50% for megestrol acetate, 40% for tamoxifen, and 30% for testosterone propionate, and 20% for gemcitabine at 10 × peak plasma concentration (Cmax). There was a trend toward higher IR for megestrol acetate and tamoxifen in the 100% progesterone receptor expression subgroup. Six patients received endocrine therapy with tamoxifen plus megestrol acetate. Tumor regression was observed in two patients.</div></div><div><h3>Conclusions</h3><div>This largest-to-date retrospective study demonstrated the chemoresistant nature of SPN, survival benefits from cytoreductive therapy, and preliminary clinical response of endocrine therapy. The combination of tamoxifen and megestrol acetate is worthy of further exploration.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100266"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular classification of microsatellite-instable colorectal cancers reveals distinct predictors of immunotherapy response","authors":"C. Lin ,&nbsp;T. Luo ,&nbsp;M. Wu ,&nbsp;F. Li ,&nbsp;L. Nunes ,&nbsp;A. Mezheyeuski ,&nbsp;K. Hammarström ,&nbsp;A. Isaksson ,&nbsp;I. Ljuslinder ,&nbsp;M. Uhlén ,&nbsp;R. Palmqvist ,&nbsp;S. Zhu ,&nbsp;B. Glimelius ,&nbsp;K. Wu ,&nbsp;T. Sjöblom","doi":"10.1016/j.esmogo.2025.100268","DOIUrl":"10.1016/j.esmogo.2025.100268","url":null,"abstract":"<div><div>Microsatellite-instable (MSI) tumours constitute one-fifth of colorectal cancers (CRCs). However, the MSI CRCs display substantial tumour microenvironment (TME) heterogeneity and variable responses to immunotherapy, necessitating a refined classification to guide personalized therapy. In this study, we analysed whole-genome and transcriptome sequences from 223 MSI CRC patients from a large prospective longitudinal cancer study in Sweden (Nunes L, Li F, Wu M, et al. Prognostic genome and transcriptome signatures in colorectal cancers. <em>Nature.</em> 2024;633(8028):137-146) and identified three molecular subclasses with distinct TME and genetic features: class 1a (immune-excluded), characterized by prominent stromal activation, transforming growth factor-β signalling, and low tumour neoantigen burdens (TNB); class 1b (immune-infiltrated), marked by intact neoantigen presentation and strong antitumour immunity; and class 2 (immune-cold), exhibiting epithelial features, high tumour mutation burden (TMB) and TNB, chromosomal instability, active metabolism, and a lack of immune activation. We further uncovered a correlation between mutL homolog 1 (<em>MLH1</em><em>)</em> hypermethylation and the immune-cold phenotype in class 2, where anti-programmed cell death protein 1 (PD-1) and anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4) combination immunotherapy demonstrated significantly improved efficacy compared with anti-PD-1 monotherapy. Finally, the molecular features of these subclasses were validated in external MSI CRC cohorts and in MSI tumours from other cancers. Our findings offer a comprehensive understanding of the molecular landscape of MSI CRC, unveiling potential molecular mechanisms underlying different tumour-immune phenotypes and laying the foundation for future development of tailored treatment strategies.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world treatment patterns and outcomes in biliary tract cancer: a Danish retrospective cohort study","authors":"A. Markussen ,&nbsp;T.D. Christensen ,&nbsp;L. Kaerlev ,&nbsp;K. Madsen ,&nbsp;S. Theile ,&nbsp;N.A. Schultz ,&nbsp;P.N. Larsen ,&nbsp;G.L. Willemoe ,&nbsp;D.L. Nielsen ,&nbsp;J.S. Johansen ,&nbsp;I.M. Chen ,&nbsp;F.O. Larsen","doi":"10.1016/j.esmogo.2025.100262","DOIUrl":"10.1016/j.esmogo.2025.100262","url":null,"abstract":"<div><h3>Background</h3><div>Despite recent treatment advancements, comprehensive real-world data on biliary tract cancer (BTC) treatment patterns and outcomes are essential. In this retrospective study, we assessed real-world treatment patterns and survival outcomes in a Danish cohort of patients with BTC.</div></div><div><h3>Methods</h3><div>Patients were identified using International Classification of Diseases, 10th Revision (ICD-10) codes in the Danish National Patient Register (period: 1 January 2010 to 31 December 2020). Prespecified data from the patients’ medical files were recorded.</div></div><div><h3>Results</h3><div>We identified 1340 patients and confirmed the diagnosis in 1028. This high misclassification rate was partly due to a broad inclusion of ICD-10 codes, including non-BTC-specific codes, and partly due to a true misclassification of other cancers. Based on the initial treatment strategy, surgery was possible for 277 patients (27.0%) with five perioperative deaths (1.8%), a recurrence rate of 68.8%, and a median overall survival of 29.9 months (95% confidence interval 26.2-36.6 months). Palliative chemotherapy was administered to 504 (49.0%) patients; 247 (24.0%) received no treatment. Combining patients with upfront unresectable disease and those with recurrent disease, 628 initiated first-line palliative chemotherapy; most received a combination treatment containing either oxaliplatin (<em>n</em> = 294, 46.8%) or cisplatin (<em>n</em> = 232, 36.9%). The median overall survival for treatment with cisplatin/gemcitabine was 11.2 months (95% confidence interval 9.5-13.1 months).</div></div><div><h3>Conclusion</h3><div>We comprehensively described the real-world treatment patterns in a Danish cohort of patients with BTC; specific ICD-10 codes could reliably identify this cohort of patients. Our findings highlight the need for improved treatment strategies in adjuvant and palliative settings.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100262"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durvalumab plus gemcitabine-cisplatin versus S-1 plus gemcitabine-cisplatin in advanced biliary tract cancer: a comparative study","authors":"T. Satake,&nbsp;M. Sasaki,&nbsp;H. Imaoka,&nbsp;S. Taro,&nbsp;K. Inoue,&nbsp;T. Taira,&nbsp;G. Igarashi,&nbsp;M. Amisaki,&nbsp;H. Takahashi,&nbsp;S. Mitsunaga,&nbsp;M. Ikeda","doi":"10.1016/j.esmogo.2025.100265","DOIUrl":"10.1016/j.esmogo.2025.100265","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Following the TOPAZ-1 trial, chemoimmunotherapy with durvalumab plus gemcitabine and cisplatin (GCD) became the standard first-line treatment of advanced biliary tract cancer (BTC). This study aimed to compare the therapeutic efficacy of GCD and gemcitabine, cisplatin, and S-1 (GCS).</div></div><div><h3>Methods</h3><div>This single-center, retrospective study consecutively included patients with advanced BTC receiving primary treatment with GCD or GCS between November 2018 and August 2024.</div></div><div><h3>Results</h3><div>A total 265 patients with advanced BTC were included: 97 were treated with GCD and 168 were treated with GCS. Median overall survival (OS) was 17.1 months [95% confidence interval (CI) 12.7-20.6 months] in the GCD group versus 18.3 months (95% CI 15.4-20.4 months) in the GCS group, with no statistically significant difference (<em>P</em> = 0.509). Median progression-free survival (PFS) was 8.0 months (95% CI 5.9-9.6 months) in the GCD group versus 8.9 months (95% CI 7.1-11.4 months) in the GCS group (<em>P</em> = 0.077). No differences were noted in objective response rates, whereas median duration of response (DoR) was significantly longer in the GCS group (12.7 months) than that in the GCD group (7.5 months) (<em>P</em> = 0.022). Patients with <em>ARID1A</em> or <em>PIK3CA</em> alterations, or with <em>SMAD4</em> wild-type, had better OS with GCS than with GCD.</div></div><div><h3>Conclusion</h3><div>GCD and GCS provide comparable survival outcomes and safety in clinical practice, with a significantly longer DoR in the GCS group. Alongside GCD, GCS represents one of the standard treatment options for advanced BTC.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100265"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA as a predictor of response and prognosis in rectal cancer treated with total neoadjuvant therapy (JCOG2010A1-ctTNT study)","authors":"T. Hashimoto ,&nbsp;H. Hirano ,&nbsp;A. Takashima ,&nbsp;S. Sekine ,&nbsp;K. Kanato ,&nbsp;J. Mizusawa ,&nbsp;H. Fukuda ,&nbsp;S. Tsukamoto ,&nbsp;Y. Kanemitsu","doi":"10.1016/j.esmogo.2025.100212","DOIUrl":"10.1016/j.esmogo.2025.100212","url":null,"abstract":"<div><div>JCOG2010A1 is a multi-institutional prospective observational study evaluating circulating tumor DNA (ctDNA) as a biomarker for minimal residual disease (MRD) detection in rectal cancer patients undergoing total neoadjuvant therapy (TNT) with active surveillance. This companion study to the JCOG2010 phase II/III trial addresses a critical clinical challenge: determining optimal treatment pathways between surgery and non-operative management following TNT. While TNT with active surveillance represents a promising organ-preserving strategy for patients achieving clinical complete response, reliable biomarkers for residual disease assessment remain lacking. ctDNA has emerged as a highly sensitive biomarker for MRD detection across multiple cancer types. The Signatera™ personalized tumor-informed assay will be utilized for ctDNA analysis throughout the treatment journey, potentially enabling more precise, individualized decision making.<ul><li><span>•</span><span><div>Collect baseline tumor tissue and blood samples, followed by serial plasma collection at predetermined timepoints throughout the protocol treatment period, including post-TNT assessment and during active surveillance.</div></span></li><li><span>•</span><span><div>Analyze ctDNA using the Signatera™ personalized tumor-informed assay to detect minimal residual disease after TNT, with results correlated to clinical and radiological findings.</div></span></li><li><span>•</span><span><div>Compare recurrence-free survival, organ preservation rates, and overall survival based on ctDNA status at multiple timepoints to assess its utility as a prognostic and predictive biomarker for treatment decision making.</div></span></li></ul></div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of the multidisciplinary team activity in patients with hepatocellular carcinoma and their survival outcomes","authors":"V. Guarini ,&nbsp;C. Garzòn ,&nbsp;D. Casado ,&nbsp;M. Casanova ,&nbsp;P. Villarejo ,&nbsp;I. Azinovic ,&nbsp;E. Crespo ,&nbsp;I. Fernandez ,&nbsp;M. Lopez ,&nbsp;M.M. de Bourio ,&nbsp;M. Moran ,&nbsp;M. Jimenez ,&nbsp;G. Medrano ,&nbsp;V. Castellano ,&nbsp;A. Lamarca","doi":"10.1016/j.esmogo.2025.100263","DOIUrl":"10.1016/j.esmogo.2025.100263","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) is the most common primary liver cancer, with increasing incidence, morbidity, and mortality. Although viral aetiologies are declining, metabolic disorders are emerging as the leading cause. Given the growing range of therapeutic options, effective management of HCC requires a multidisciplinary approach.</div></div><div><h3>Patients and methods</h3><div>This retrospective study analysed patients with HCC who were discussed by a multidisciplinary team (MDT). The study aimed to describe patient characteristics, treatment recommendations, and survival outcomes, including progression-free survival (PFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>A total of 134 patients were included, with a median age of 68.2 years. Most were male (84.3%) and had an Eastern Cooperative Oncology Group performance status of 1 (67.2%). The majority had early-stage disease (62.7% in Barcelona Clinic Liver Cancer stage 0-A) and multiple comorbidities. We identified that 65 (48.5%) patients were presented in the MDT once, while 69 (51.5%) patients were presented two or more times. The median number of discussions per patient was 2 (range 1-8). Most patients discussed more than once were those diagnosed with early-stage disease at initial presentation. Treatment varied by stage: local ablative therapy was used in 54.8% of early-stage patients, locoregional therapy (LRT) in 37.9% of intermediate stage patients, and systemic therapy in 37.9% of intermediate-stage and 57.1% of advanced-stage patients. The median OS for the full cohort was 20.89 months [95% confidence interval (CI) 16.26-26.78]. Among LRTs, the median PFS was 24.46 months (95% CI 7.93-35.34) for transarterial chemoembolization and 27.77 months (95% CI 4.46-not reached months) for transarterial radioembolization. For systemic therapy, the median PFS was 13.65 months (95% CI 5.36-not reached months) with atezolizumab-bevacizumab and 4.59 months (95% CI 3.01-not reached) with sorafenib.</div></div><div><h3>Conclusion</h3><div>The study underscores the value of MDT-driven management in HCC, facilitating individualized, stage-specific treatment decisions. Repeated MDT evaluations are crucial for guiding patient care throughout the disease course.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"10 ","pages":"Article 100263"},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}