Ep. 64 Evolving Perioperative Management Strategies for Gastric & GE Junction Cancers with Dr. Michael Gibson

Is personalized, surgery-sparing treatment becoming a reality for patients with gastric adenocarcinoma? In this episode of BackTable Tumor Board, Dr. Eric Lander and Dr. Michael Gibson break down the rapidly changing landscape of treatment for resectable gastric and gastroesophageal junction adenocarcinoma. They trace the evolution from surgery as the standard, through difficult postoperative chemoradiation and perioperative chemotherapy (MAGIC, FLOT4), to the new strategies that are moving beyond traditional chemoradiation in the wake of the ESOPEC trial. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by AstraZenecahttps://www.astrazeneca.com/our-therapy-areas/oncology/gastrointestinal-cancer.html --- Timestamps 00:00 - Introduction 09:41 - FLOT Becomes Standard19:54 - Keynote 585 and Matterhorn28:35 - Managing DFL Toxicity35:10 - Path CR and Deescalation38:46 - Future Directions and Organ Preservation --- More about this episode The conversation highlights the Matterhorn trial’s positive results with durvalumab added to perioperative FLOT, including manageable toxicity and benefits seen across PD-L1 expression levels. Lander and Gibson share practical management tips for patients who cannot tolerate FLOT, staging nuances like selective diagnostic laparoscopy, and future directions such as targeted therapy combinations, total neoadjuvant approaches, ctDNA-guided de-escalation, and organ preservation for MSI-high disease. --- Resources Matterhorn Trialhttps://www.nejm.org/doi/abs/10.1056/NEJMoa2503701 ESOPEC Studyhttps://www.nejm.org/doi/abs/10.1056/NEJMoa2409408 CheckMate 577https://www.nejm.org/doi/full/10.1056/NEJMoa2032125 --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app