Institute of Medical Science

University of Toronto

Dr. Arndt Vogel made several notable contributions to the discussions at ASCO GI 2026:

1. ALTOPANC Study: Dr. Vogel discussed the promising activity of local ablative therapies in oligometastatic pancreatic adenocarcinoma, using the ALTOPANC score to help select patients for MDT. Link

2. COMMIT and BREAKWATER: He presented detailed analyses of the BREAKWATER and COMMIT trials, showcasing the potential of EC + FOLFIRI as a new treatment standard for BRAF V600E-mutant mCRC and highlighting the striking PFS benefits in the COMMIT trial, despite the controversies surrounding the atezolizumab arm's performance. Link

3. HERIZON-GEA-01: Dr. Vogel emphasized the positive outcomes of the HERIZON-GEA-01 trial for Zanidatamab in combination with chemotherapy, noting its potential to reshape treatment strategies for HER2-positive metastatic gastroesophageal adenocarcinoma. Link

4. ILUSTRO Trial: He discussed the promising results from the ILUSTRO Phase II trial, where zolbetuximab plus mFOLFOX6 and nivolumab showed interesting activity in CLDN18.2-positive gastric and gastroesophageal junction adenocarcinoma, especially in high-expression subgroups. Link

5. KRAS and FGFR2 Research: Presented findings from early-phase studies such as INCB161734 for targeting KRAS G12D mutations in PDAC and lirafugratinib for FGFR2-driven cholangiocarcinoma, highlighting the expanding landscape of targeted treatments. Link

6. CRITICS-II Trial: He reported on different neoadjuvant strategies for resectable gastric cancer, indicating the CT → CRT approach showed the most promise, warranting further study with potential organ-sparing strategies. Link

Cedars-Sinai

Dr. Jun Gong actively contributed to discussions at the ASCO GI 2026 conference by presenting several key findings and analyses:

1. DISCO Trial: Dr. Gong highlighted that DW-MRI reduces futile surgical procedures in patients with colorectal peritoneal metastases compared to standard staging with laparoscopy, thereby enhancing patient selection and surgical decisions. Link

2. PLATO ACT5 RCT: He discussed the results of dose-escalated IMRT in T3/4N0 anal SCC, indicating no improvement in early outcomes compared to standard IMRT. Link

3. TriNetX RW Analysis: Conducted a real-world analysis demonstrating that GLP-1RA is associated with a 26% reduced risk of CRC compared to aspirin, consistent across sensitivity analyses and subgroups. Link

4. FOXTROT Study: Shared a post-hoc analysis showing no association between ERBB2 expression and outcomes, but identified high ERBB3 expression as a predictor of benefit from treatment, independent of other EGFR ligands. Link

5. HCC Treatment Strategies: Highlighted emerging strategies like TACE combined with immunotherapy as a promising approach over TACE alone for intermediate-stage HCC. Link

6. KN-937 Trial: Provided insights into the KN-937 trial, noting the lack of significant improvement in recurrence-free survival with pembrolizumab in the adjuvant setting post-surgery for HCC, aligning with prior negative trials. Link

Vanderbilt-Ingram Cancer Center

Dr. Cathy Eng provided insights into several significant studies and updates at ASCO GI 2026:

1. BREAKWATER Analysis: Dr. Eng highlighted the efficacy of encorafenib + cetuximab + FOLFIRI in BRAF V600E mutant mCRC, showing superior ORR compared to standard chemotherapy, and discussed the anticipated data on PFS and OS with longer follow-up. Link

2. HERIZON-GEA-01 Highlights: She noted the potential practice-changing results of the HERIZON-GEA-01 trial with Zanidatamab in combination with chemotherapy and immunotherapy, emphasizing its positive outcomes compared to current HER2-targeted treatments. Link

3. Keynote-937 Commentary: Dr. Eng discussed the disappointing outcomes of Keynote-937 in the adjuvant setting for HCC, aligning with prior negative results from other adjuvant immunotherapy trials in this population, and highlighted no difference in OS or RFS. Link

4. KRAS G12D Inhibition: She provided insights into the preliminary phase 1 results of the novel KRAS G12D inhibitor, INCB161734, reporting manageable safety and early efficacy signals in metastatic PDAC. Link

Dr. Rohit Gosain: Roswell Park Comprehensive Cancer Center

Dr. Rahul Gosain: Wilmot Cancer Institute

The Oncology Brothers contributed insights and summaries of multiple significant trials presented at ASCO GI 2026:

1. HERIZON-GEA-01: They summarized the HERIZON-GEA-01 trial's outcomes, highlighting the promise of Zanidatamab plus chemotherapy, with or without Tislelizumab, for HER2-positive metastatic gastroesophageal adenocarcinoma, noting its potential practice-changing implications. Link

2. BREAKWATER: Discussed the positive outcomes of the BREAKWATER Phase III trial, demonstrating a significant improvement in ORR and a trend towards better overall survival for Encorafenib + Cetuximab + FOLFIRI in BRAF V600E-mutant mCRC. Highlighted the FDA's approval of this regimen as the standard of care. Link

3. COMMIT Trial: Provided a breakdown of the COMMIT trial's results, showing the superiority of Atezolizumab combined with chemotherapy and bevacizumab over Atezolizumab alone in patients with dMMR/MSI-H mCRC, with notable differences in ORR and mPFS. Link

4. GALAXY Trial: Highlighted the role of ctDNA in predicting recurrence risk and potentially sparing adjuvant chemotherapy in stage II-III rectal cancer, discussing its prognostic and predictive value in the context of the TNT approach. Link

5. ILUSTRO Trial: Provided an update on the ILUSTRO Phase II trial, emphasizing the role of Nivolumab plus Zolbetuximab and chemotherapy in improving mPFS and its dependence on high expression of CLDN18.2 and CPS. They signposted the need for the forthcoming Phase III LUCERNA study. Link

6. General Conference Highlights: The Oncology Brothers provided a comprehensive overview of the GI26 conference highlights, covering various important trials like HERIZON-GEA-01, BREAKWATER, and COMMIT, along with other notable studies in the GI oncology space. Link

Northwell Health

Dr. Nicholas Hornstein contributed to the discussions at ASCO GI 2026 through various insightful analyses and commentary:

1. ctDNA's Impact on GI Oncology: Dr. Hornstein remarked on the transformative potential of circulating tumor DNA (ctDNA) in shaping gastrointestinal oncology. He noted the enormous interest and discussion surrounding ctDNA, highlighting its potential to significantly impact patient care. Link

2. Discussions on BREAKWATER Regimen: He commented on the BREAKWATER Cohort 3 findings, analyzing the role of encorafenib + cetuximab + FOLFIRI as a key non-oxaliplatin option in treating BRAF V600E mutant mCRC, particularly noting its relevance in different geographical treatment settings. Link

3. COMMIT Trial Insights: Dr. Hornstein highlighted the dramatic differences in progression-free survival and in the COMMIT trial. Link

4. Early Phase Novel Therapies: Dr. Hornstein showed interest in discussions on early-phase data for potential breakthrough therapies, including INCB161734, emphasizing the importance of paying attention to clear signals in rare cancers. Link

City of Hope

Dr. Pashtoon Kasi contributed valuable insights and analyses on several trials and discussions at ASCO GI 2026:

1. COMMIT Trial Reflections: Dr. Kasi questioned the underperformance of Atezolizumab monotherapy as compared to other immunotherapies like Nivolumab and Pembrolizumab, suggesting that such insights should prompt a reevaluation of treatment strategies in MSI-H/dMMR mCRC. He emphasized that monotherapy with Atezo appears to underperform when matched against prior immune-oncology data. Link

2. BREAKWATER Results: Dr. Kasi applauded the high response rates in the BREAKWATER trial, supporting the combination of Encorafenib, Cetuximab, and FOLFIRI as an option in first-line mCRC treatment, particularly noting the importance of findings for practice. Link

3. Safety Concerns in Trials: He raised caution over Grade 5 events in trials, specifically in MSI-H colorectal cancer settings, stressing the importance of considering safety profiles seriously in clinical decision-making. Link

Hospital Clínico Universitario de Santiago de Compostela

Dr. Nieves Martinez Lago actively contributed to the discussions at ASCO GI 2026 through various presentations and analyses:

1. BREAKWATER Cohort 3: Dr. Martinez Lago highlighted the promising results of the BREAKWATER trial for 1L BRAF V600E mutant mCRC, where Encorafenib + Cetuximab + FOLFIRI showed a superior objective response rate (ORR) and a positive trend towards overall survival compared to standard FOLFIRI ± bevacizumab. She noted the rapid and durable responses observed with manageable toxicity profiles. Link

2. COMMIT Trial: She shared insights on the COMMIT trial, emphasizing the improved progression-free survival (PFS) and overall response rates (ORR) for Atezolizumab combined with mFOLFOX6 and Bevacizumab over Atezolizumab monotherapy in the treatment of dMMR/MSI-H mCRC. Link

3. HERIZON-GEA-01: Dr. Martinez Lago provided an analysis of the HERIZON-GEA-01 trial, showcasing zanidatamab's effectiveness as a new HER2-targeted therapy in combination with chemotherapy, achieving significant improvements in progression-free survival (PFS) and overall survival (OS) in HER2+ mGEA, and maintaining a manageable safety profile. Link

4. Emerging Targeted Therapies: She emphasized the importance of targeting CLDN18.2 in gastric and gastroesophageal junction adenocarcinoma, sharing results from the ILUSTRO Phase II trial which demonstrated notable efficacy, particularly in high CLDN18.2 expression cohorts. Link

5. Neoadjuvant Strategies in Gastric Cancer: Highlighted the CRITICS-II trial exploring various neoadjuvant strategies, remarking on the success of chemotherapy followed by chemoradiotherapy, which showed improved efficacy outcomes, supporting it as an encouraging approach for further study in resectable gastric cancer. Link

Dr. Martinez Lago’s contributions were pivotal in interpreting complex clinical trial data, indicating new directions in treatment options for various GI cancers.

National Cancer Center Hospital East

Dr. Daisuke Kotani contributed detailed analyses and insights into various studies at ASCO GI 2026, focusing on colorectal cancer:

1. BREAKWATER Cohort 3: Dr. Kotani highlighted the results from the BREAKWATER trial, which demonstrated a superior objective response rate (ORR) for the combination of Encorafenib + Cetuximab + FOLFIRI compared to FOLFIRI ± bevacizumab in BRAF V600E mutant mCRC. He noted the potential of EC + FOLFIRI to emerge as a new standard of care, alongside EC + FOLFOX. Link

2. COMMIT Trial: In his analysis of the COMMIT trial results, Dr. Kotani discussed the significant progression-free survival (PFS) benefits of combining FOLFOX and bevacizumab with Atezolizumab compared to Atezolizumab alone in dMMR/MSI-H mCRC. He pointed out that outcomes in the Atezolizumab arm appeared inferior to other immunotherapies like Pembrolizumab or Nivolumab, which calls for a closer examination of treatment choices. Link

3. ALTAIR Study Analysis: He emphasized the importance of pre-specified central review in the ALTAIR study, focusing on its impact in correctly assessing disease-free survival (DFS) to determine the efficacy of FTD/TPI versus placebo in ctDNA+ CRC patients post-surgery. Link

4. Immunotherapy Insights: Dr. Kotani contributed to ongoing conversations about the relative performance of different immunotherapies, questioning the results of Atezolizumab and considering alternative strategies in settings like MRD+ where treatment outcomes could be influenced by various factors. Link

City of Hope

Dr. Daneng Li's contributions to the #GI26 discussions reflect a thoughtful consideration of ongoing and emerging oncology treatments and trials. His commentary underscores the critical role that continual evaluation and integration of new data play in oncology.

1. BREAKWATER Trial Commentary: Dr. Li commented on the promising OS trend in the BREAKWATER results, highlighting the need for novel mechanisms to further improve treatment in aggressive colorectal cancer populations already receiving quadruple therapy combinations.  Link

2. HCC Adjuvant Trials Insight: He reflected on the negative outcome of the Keynote-937 study for adjuvant HCC, pointing out that despite the alignment with previous results (like IMbrave 050), there is a significant need for new strategies due to the unique challenges presented by adjuvant population and underlying liver cirrhosis in HCC. Link

3. Broader Implications for Patient Care: In conversation with Dr. Jun Gong, he emphasized the importance of re-evaluating studies when new data emerges, advocating for patient-first approaches that adapt to advances in care.  Link