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CRITICS-II

About the CRITICS-II Trial



Table of Contents

Major Presentations and Milestones

CRITICS-II Trial design, results, and conclusions

CRITICS-II Sentiments and Criticisms

CRITICS-II Temporal Sentiment Arc

Professional Resources : Interactive Tweet History, Influence Diagram, Sentiment Table, AI Chatbot

CRITICS-II Trial: Major Presentations and Milestones

Primary speakers driving the story

At ASCO GI 2026 (#GI26), CRITICS-II was discussed as a multicenter phase II randomized effort to refine perioperative strategies for resectable gastric cancer by testing different neoadjuvant intensification approaches without adjuvant therapy. KOL commentary focused on the comparative tradeoffs across three strategies—efficacy, toxicity, and feasibility—while also highlighting how quickly the perioperative standard of care is evolving (e.g., D-FLOT adoption and perioperative immunotherapy).

Arndt Vogel, MD summarized the “three-arm story” succinctly for clinicians: arm 1 had the lowest efficacy, arm 2 appeared to have longer OS, and arm 3 had less toxicity—leading to the practical inference that arm 2 “seems preferred,” at least within the constraints of a phase II selection design.

CRITICS-II Trial Design, Results, and Conclusions

Trial Design:

CRITICS-II is a multicenter phase II randomized trial in resectable gastric cancer evaluating three neoadjuvant strategies, with no adjuvant therapy planned (per KOL summaries):

Arm 1: neoadjuvant chemotherapy (CT) alone

Arm 2: neoadjuvant chemotherapy followed by chemoradiotherapy (CT → CRT; “TNT” approach)

Arm 3: neoadjuvant chemoradiotherapy (CRT) alone

Key Efficacy Results (as reported in tweets):

Martinez Lago reported that the CT-alone arm did not meet the event-free survival (EFS) threshold, and provided the 1-year EFS rates across arms:

EIOC summarized a related efficacy endpoint signal, noting improved 1-year EFS and a pathologic complete response signal for the combined approach:

Safety / tolerability:

Vogel’s summary emphasized a tradeoff: arm 3 (CRT alone) had “less tox,” whereas arm 2 appeared preferred on efficacy/OS considerations. https://x.com/ArndtVogel/status/2009444482492846427

Key Conclusions:

Within the limitations of a phase II selection framework and based on the reported #GI26 summaries, CRITICS-II supports CT → CRT as the most promising neoadjuvant strategy among those tested, showing the highest reported 1-year EFS and a pCR signal, while acknowledging toxicity/feasibility considerations. Multiple commentators also stressed that the trial was conducted in an earlier systemic-therapy era, which complicates direct translation to current practice.

CRITICS-II Sentiments and Criticisms

Positive Reception (signal and “what to do next”):

Nieves Martinez Lago, MD, PhD: “➡️ CT+CRT selected for further study, incl. organ-sparing approaches” https://x.com/DraMartinezLago/status/2009304426746679592

Arndt Vogel, MD: “🤔 Arm 2 seems preferred option” https://x.com/ArndtVogel/status/2009444482492846427

Critical Perspectives (era-of-care and integration with modern regimens):

EIOC emphasized the “moving target” problem in perioperative gastric cancer:

EIOC: “trial conducted in an era where Dflot not standard of care. Furthermore now Matterhorn is standard of care” and asked: “question is can chemoRT be integrated w/o compromising completion of modern intensified systemic therapies?” https://x.com/EiocOncology/status/2009462466363970015

CRITICS-II Temporal Sentiment Arc

January 2026 (ASCO GI 2026: initial interpretation and positioning)

Primary/KOL tweets:

Overall, the early CRITICS-II sentiment arc is characterized by cautious optimism around a TNT-style approach (CT→CRT) for resectable gastric cancer, coupled with a strong methodological and implementation caveat: the clinical utility depends on feasibility alongside contemporary perioperative systemic intensification.

CRITICS-II Professional Resources