Interpretation of advances in the treatment of esophageal cancer and gastroesophageal junction cancer at the 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Jiahe ^1,2 , LU Jiayu ³ , ZHANG Xuxu ^1,2 , XU Xinyao ¹ , ZHANG Jipeng ¹ , LI Wei ¹ , LI Guizhen ¹ ,  LU Qiang ¹

1. Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, P. R. China;
2. Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, P. R. China;
3. Basic Medical College, Air Force Medical University, Xi'an, 710032, P. R. China;

Corresponding author：

LU Qiang, Email: luqiang@fmmu.edu.cn

Keywords：

Esophageal cancer; gastric cancer; American Society of Clinical Oncology Gastrointestinal Cancers Symposium; advanced-stage treatment; perioperative treatment; interpretation

DOI：

10.7507/1007-4848.202504032

Video：

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[Abstract] The 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI) has concluded. Several significant studies on the treatment of esophageal and gastroesophageal junction (GEJ) cancer were presented at the symposium, highlighting notable advances, particularly in the perioperative and advanced settings. Immunotherapy has demonstrated significant promise in the neoadjuvant treatment of esophageal cancer, showing potential to become a standard of care. Furthermore, the long-term survival benefits of combining immunotherapy with chemotherapy for advanced GEJ cancer were further validated. This article summarizes and interprets the research presented at the symposium concerning perioperative and advanced treatments for esophageal and GEJ cancers.

1.	Morgan E, Soerjomataram I, Rumgay H, et al. The global landscape of esophageal squamous cell carcinoma and esophageal adenocarcinoma incidence and mortality in 2020 and projections to 2040: New estimates from GLOBOCAN 2020. Gastroenterology, 2022, 163(3): 649-658.
2.	Singh A. Global burden of five major types of gastrointestinal cancer. Prz Gastroenterol, 2024, 19(3): 236-254.
3.	Yan Y, Feng X, Li C, et al. Treatments for resectable esophageal cancer: from traditional systemic therapy to immunotherapy. Chin Med J (Engl), 2022, 135(18): 2143-2156.
4.	中国抗癌协会食管肿瘤整合康复专业委员会, 陈小兵. 食管癌免疫检查点抑制剂临床应用全程管理专家共识. 中国医学前沿杂志(电子版), 2024, 16(7): 1-21.
5.	Leng X, He W, Lyu J, et al. Preliminary results from the multicenter, randomized phase Ⅲ trial (SCIENCE): Comparing chemotherapy plus sintilimab and chemoradiotherapy plus sintilimab versus chemoradiotherapy for neoadjuvant treatment in resectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4_suppl): LBA329.
6.	Dai L, Wu Y, Tian Z, et al. Perioperative adebrelimab combined with chemotherapy for locally advanced resectable esophageal squamous cell carcinoma: A single-arm, open-label, multicenter study. J Clin Oncol, 2025, 43(4_suppl): 421.
7.	Li Z, Yang Y, Liu Z, et al. Neoadjuvant adebrelimab plus chemotherapy for resectable locally advanced esophageal squamous cell carcinoma: A phase 2 trial. J Clin Oncol, 2025, 43(4_suppl): 443.
8.	Wang M, Dong W, Wu G, et al. Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II-IVa esophageal cancer: A network meta-analysis. Syst Rev, 2025, 14(1): 26.
9.	Liu C, Huang W, Fu C, et al. Neoadjuvant SHR-1701 (a bifunctional anti-PD-L1/TGF-βRII agent) combined with chemoradiotherapy for resectable locally advanced esophageal squamous cell carcinoma (ESCC): A phaseⅡ trial. J Clin Oncol, 2025, 43(4_suppl): 410.
10.	Okui J, Nagashima K, Matsuda S, et al. Recurrence-free survival as a surrogate endpoint for overall survival after neoadjuvant chemotherapy and surgery for oesophageal squamous cell carcinoma. Br J Surg, 2024, 111(2): znae038.
11.	Cabrit N, Cheugoua-Zanetsie M, Tierney J, et al. Disease-free survival as surrogate for overall survival in esophageal cancer: An individual patient data meta-analysis of neoadjuvant chemotherapy and chemoradiotherapy. Eur J Cancer, 2025, 218: 115292.
12.	Okui J, Nagashima K, Matsuda S, et al. Surrogacy between pathological complete response and overall survival: An individual patient data analysis of eight RCTs on neoadjuvant treatment plus surgery for esophageal cancer. J Clin Oncol, 2025, 43(4_suppl): 498.
13.	Guo C, Li X, Chen S, et al. Anlotinib plus benmelstobart as adjuvant therapy in patients with esophageal squamous cell carcinoma: A phase Ⅱ clinical trial (ALTER-E005). J Clin Oncol, 2025, 43(4_suppl): 459.
14.	Chang Z, Wang R-R, Liu X-L, et al. Anlotinib combined with penpulimab and nab-paclitaxel as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, open-label phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4_suppl): 367.
15.	Wang Y, Liu H, Wang Q, et al. Bifunctional anti-PD-L1/TGF-βRII agent SHR-1701 plus chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Survival results of a phase Ⅱ trial. J Clin Oncol, 2025, 43(4_suppl): 411.
16.	Xin D, Song Y, Mu L, et al. The efficacy and safety of nanoparticle albumin bound-paclitaxel-based regimen as second- or third-line treatment in patients with advanced esophageal squamous cell carcinoma. Thorac Cancer, 2023, 14(15): 1392-1397.
17.	Fukuoka S, Machida N, Mitani S, et al. Zimberelimab platform study: Safety and efficacy of zimberelimab in combination with futibatinib and chemotherapy in patients with first-line advanced or metastatic esophageal carcinoma. J Clin Oncol, 2025, 43(4_suppl): 409-409.
18.	Qu W, Gao J, Zhang B, et al. Efficacy, safety and DNA methylation analysis of cadonilimab combined with taxane and cisplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Updated results from an open-label, multicenter phaseⅡ trial (AK104-IIT-014). J Clin Oncol, 2025, 43(4_suppl): 463.
19.	Sano M, Yamamoto S, Shiraishi K, et al. The safety and short-term efficacy of induction DCF plus nivolumab therapy in patients with unresectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4_suppl): 425.
20.	Gu Y, Qiu T, Mingjie L, et al. Fruquintinib plus camrelizumab combined with paclitaxel liposome and nedaplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4_suppl): 445.
21.	Nie K, Han X, Zhang L, et al. Chemoimmunotherapy plus radiotherapy in advanced esophageal squamous-cell carcinoma. J Clin Oncol, 2025, 43(4_suppl): 437-437.
22.	Doki Y, Ajani JA, Kato K, et al. Nivolumab combination therapy in advanced esophageal squamous-cell carcinoma. N Engl J Med, 2022, 386(5): 449-462.
23.	Kojima T, Shah MA, Muro K, et al. Randomized phase Ⅲ KEYNOTE-181 study of pembrolizumab versus chemotherapy in advanced esophageal cancer. j clin oncol, 2020, 38(35): 4138-4148.
24.	Guo J-C, Lin P-S, Shau W-Y, et al. Does chemotherapy regimen matter for first-line immunochemotherapy in low programmed cell death ligand 1 (PD-L1)-expressing esophageal squamous cell carcinoma (ESCC)? A systemic review and meta-analysis. J Clin Oncol, 2025, 43(4_suppl): 395-395.
25.	Wu HX, Pan YQ, He Y, et al. Clinical benefit of first-line programmed death-1 antibody plus chemotherapy in low programmed cell death ligand 1-expressing esophageal squamous cell carcinoma: A post hoc analysis of JUPITER-06 and meta-analysis. J Clin Oncol, 2023, 41(9): 1735-1746.
26.	Wang X, Feng G, Fu C, et al. Preliminary results of the ALTER-E009 study: Efficacy and safety of anlotinib combined with radiotherapy in patients with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC): A multicenter, multi-cohort retrospective exploratory study. J Clin Oncol, 2025, 43(4_suppl): 361.
27.	Shen L, Bai Y, Lin X, et al. First-line (1L) nivolumab (NIVO) plus chemotherapy (chemo) vs chemo in patients (pts) with advanced gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up of Chinese pts from CheckMate 649. J Clin Oncol, 2025, 43(4_suppl): 392.
28.	Janjigian YY, Moehler MH, Ajani JA, et al. Nivolumab (NIVO) + chemotherapy (chemo) vs chemo as first-line (1L) treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up results from CheckMate 649. J Clin Oncol, 2025, 43(4_suppl): 398.
29.	Yen CJ, Oh D-Y, Bai Y, et al. Pembrolizumab or placebo plus chemotherapy for advanced HER2-negative gastric or gastroesophageal junction (G/GEJ) adenocarcinoma: An updated analysis of KEYNOTE-859 for patients enrolled in Asia. J Clin Oncol, 2025, 43(4_suppl): 464.
30.	Jia Y-X, Chang Z, Zhong Y-L, et al. Preliminary results of benmelstobart plus anlotinib combined with SOX in the first-line treatment of advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma with low PD-L1 expression: A single-arm, multicenter phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4_suppl): 444.
31.	Meng X, Shan Z, Guan L, et al. Updated results from the phaseⅠb/Ⅱstudy of fruquintinib combined with SOX and toripalimab in patients with advanced metastatic gastric/gastroesophageal junction adenocarcinoma (GC/GEJC). J Clin Oncol, 2025, 43(4_suppl): 423.

1. Morgan E, Soerjomataram I, Rumgay H, et al. The global landscape of esophageal squamous cell carcinoma and esophageal adenocarcinoma incidence and mortality in 2020 and projections to 2040: New estimates from GLOBOCAN 2020. Gastroenterology, 2022, 163(3): 649-658.
2. Singh A. Global burden of five major types of gastrointestinal cancer. Prz Gastroenterol, 2024, 19(3): 236-254.
3. Yan Y, Feng X, Li C, et al. Treatments for resectable esophageal cancer: from traditional systemic therapy to immunotherapy. Chin Med J (Engl), 2022, 135(18): 2143-2156.
4. 中国抗癌协会食管肿瘤整合康复专业委员会, 陈小兵. 食管癌免疫检查点抑制剂临床应用全程管理专家共识. 中国医学前沿杂志(电子版), 2024, 16(7): 1-21.
5. Leng X, He W, Lyu J, et al. Preliminary results from the multicenter, randomized phase Ⅲ trial (SCIENCE): Comparing chemotherapy plus sintilimab and chemoradiotherapy plus sintilimab versus chemoradiotherapy for neoadjuvant treatment in resectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4_suppl): LBA329.
6. Dai L, Wu Y, Tian Z, et al. Perioperative adebrelimab combined with chemotherapy for locally advanced resectable esophageal squamous cell carcinoma: A single-arm, open-label, multicenter study. J Clin Oncol, 2025, 43(4_suppl): 421.
7. Li Z, Yang Y, Liu Z, et al. Neoadjuvant adebrelimab plus chemotherapy for resectable locally advanced esophageal squamous cell carcinoma: A phase 2 trial. J Clin Oncol, 2025, 43(4_suppl): 443.
8. Wang M, Dong W, Wu G, et al. Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II-IVa esophageal cancer: A network meta-analysis. Syst Rev, 2025, 14(1): 26.
9. Liu C, Huang W, Fu C, et al. Neoadjuvant SHR-1701 (a bifunctional anti-PD-L1/TGF-βRII agent) combined with chemoradiotherapy for resectable locally advanced esophageal squamous cell carcinoma (ESCC): A phaseⅡ trial. J Clin Oncol, 2025, 43(4_suppl): 410.
10. Okui J, Nagashima K, Matsuda S, et al. Recurrence-free survival as a surrogate endpoint for overall survival after neoadjuvant chemotherapy and surgery for oesophageal squamous cell carcinoma. Br J Surg, 2024, 111(2): znae038.
11. Cabrit N, Cheugoua-Zanetsie M, Tierney J, et al. Disease-free survival as surrogate for overall survival in esophageal cancer: An individual patient data meta-analysis of neoadjuvant chemotherapy and chemoradiotherapy. Eur J Cancer, 2025, 218: 115292.
12. Okui J, Nagashima K, Matsuda S, et al. Surrogacy between pathological complete response and overall survival: An individual patient data analysis of eight RCTs on neoadjuvant treatment plus surgery for esophageal cancer. J Clin Oncol, 2025, 43(4_suppl): 498.
13. Guo C, Li X, Chen S, et al. Anlotinib plus benmelstobart as adjuvant therapy in patients with esophageal squamous cell carcinoma: A phase Ⅱ clinical trial (ALTER-E005). J Clin Oncol, 2025, 43(4_suppl): 459.
14. Chang Z, Wang R-R, Liu X-L, et al. Anlotinib combined with penpulimab and nab-paclitaxel as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, open-label phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4_suppl): 367.
15. Wang Y, Liu H, Wang Q, et al. Bifunctional anti-PD-L1/TGF-βRII agent SHR-1701 plus chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Survival results of a phase Ⅱ trial. J Clin Oncol, 2025, 43(4_suppl): 411.
16. Xin D, Song Y, Mu L, et al. The efficacy and safety of nanoparticle albumin bound-paclitaxel-based regimen as second- or third-line treatment in patients with advanced esophageal squamous cell carcinoma. Thorac Cancer, 2023, 14(15): 1392-1397.
17. Fukuoka S, Machida N, Mitani S, et al. Zimberelimab platform study: Safety and efficacy of zimberelimab in combination with futibatinib and chemotherapy in patients with first-line advanced or metastatic esophageal carcinoma. J Clin Oncol, 2025, 43(4_suppl): 409-409.
18. Qu W, Gao J, Zhang B, et al. Efficacy, safety and DNA methylation analysis of cadonilimab combined with taxane and cisplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Updated results from an open-label, multicenter phaseⅡ trial (AK104-IIT-014). J Clin Oncol, 2025, 43(4_suppl): 463.
19. Sano M, Yamamoto S, Shiraishi K, et al. The safety and short-term efficacy of induction DCF plus nivolumab therapy in patients with unresectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4_suppl): 425.
20. Gu Y, Qiu T, Mingjie L, et al. Fruquintinib plus camrelizumab combined with paclitaxel liposome and nedaplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4_suppl): 445.
21. Nie K, Han X, Zhang L, et al. Chemoimmunotherapy plus radiotherapy in advanced esophageal squamous-cell carcinoma. J Clin Oncol, 2025, 43(4_suppl): 437-437.
22. Doki Y, Ajani JA, Kato K, et al. Nivolumab combination therapy in advanced esophageal squamous-cell carcinoma. N Engl J Med, 2022, 386(5): 449-462.
23. Kojima T, Shah MA, Muro K, et al. Randomized phase Ⅲ KEYNOTE-181 study of pembrolizumab versus chemotherapy in advanced esophageal cancer. j clin oncol, 2020, 38(35): 4138-4148.
24. Guo J-C, Lin P-S, Shau W-Y, et al. Does chemotherapy regimen matter for first-line immunochemotherapy in low programmed cell death ligand 1 (PD-L1)-expressing esophageal squamous cell carcinoma (ESCC)? A systemic review and meta-analysis. J Clin Oncol, 2025, 43(4_suppl): 395-395.
25. Wu HX, Pan YQ, He Y, et al. Clinical benefit of first-line programmed death-1 antibody plus chemotherapy in low programmed cell death ligand 1-expressing esophageal squamous cell carcinoma: A post hoc analysis of JUPITER-06 and meta-analysis. J Clin Oncol, 2023, 41(9): 1735-1746.
26. Wang X, Feng G, Fu C, et al. Preliminary results of the ALTER-E009 study: Efficacy and safety of anlotinib combined with radiotherapy in patients with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC): A multicenter, multi-cohort retrospective exploratory study. J Clin Oncol, 2025, 43(4_suppl): 361.
27. Shen L, Bai Y, Lin X, et al. First-line (1L) nivolumab (NIVO) plus chemotherapy (chemo) vs chemo in patients (pts) with advanced gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up of Chinese pts from CheckMate 649. J Clin Oncol, 2025, 43(4_suppl): 392.
28. Janjigian YY, Moehler MH, Ajani JA, et al. Nivolumab (NIVO) + chemotherapy (chemo) vs chemo as first-line (1L) treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up results from CheckMate 649. J Clin Oncol, 2025, 43(4_suppl): 398.
29. Yen CJ, Oh D-Y, Bai Y, et al. Pembrolizumab or placebo plus chemotherapy for advanced HER2-negative gastric or gastroesophageal junction (G/GEJ) adenocarcinoma: An updated analysis of KEYNOTE-859 for patients enrolled in Asia. J Clin Oncol, 2025, 43(4_suppl): 464.
30. Jia Y-X, Chang Z, Zhong Y-L, et al. Preliminary results of benmelstobart plus anlotinib combined with SOX in the first-line treatment of advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma with low PD-L1 expression: A single-arm, multicenter phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4_suppl): 444.
31. Meng X, Shan Z, Guan L, et al. Updated results from the phaseⅠb/Ⅱstudy of fruquintinib combined with SOX and toripalimab in patients with advanced metastatic gastric/gastroesophageal junction adenocarcinoma (GC/GEJC). J Clin Oncol, 2025, 43(4_suppl): 423.

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