S16 Ep27: Show Me the Data™—Closing Clinical Gaps in Gastric and Esophageal Cancer: Advancing Targeted Treatment Strategies Across the Care Continuum

Targeted therapies, immunotherapies, and chemotherapies are evolving the standard of care for gastric, esophageal, and gastroesophageal junction adenocarcinomas. The Matterhorn trial demonstrates that adding durvalumab to the FLOT chemotherapy backbone significantly improves event-free and overall survival in localized disease, regardless of PD-L1 status. In metastatic settings, treatment selection relies on a biomarker-driven hierarchy, prioritizing MMR, HER2, and PD-L1 testing, with emerging agents like zanidatamab showing potential for HER2-positive patients. For locally advanced esophageal squamous cell carcinoma, the SANO trial supports a watch-and-wait approach for clinical complete responders, while circulating tumor DNA (ctDNA) is increasingly utilized to monitor treatment response and guide potential therapy adjustments. Despite these advancements, managing regimen-related toxicities—such as diarrhea with zanidatamab and nausea with zolbetuximab—remains critical to ensuring patients complete necessary treatment cycles.