🍽️ GI Cancer — 2026-W40

What this page is. Every paper the week's monitor reviewed — including the ones that did not go into the digest. Material marked “Not selected” was reviewed and deliberately left out. It has not been fact-checked to digest standard and is not endorsed. For the curated read, see the digest itself.

Phase 3 randomized placebo-controlled trial in patients after curative-intent treatment of colorectal cancer liver metastases, published in Lancet Gastroenterology & Hepatology. Tests adjuvant aspirin for preventing recurrence, directly informing post-resection management decisions.

Phase 3 RCT reporting 5-year follow-up of adjuvant S-1 after resection of biliary tract cancer, published in JCO. Confirms a sustained overall survival benefit, solidifying adjuvant S-1 as a standard-of-care option after resection.

Phase 3 RCT in untreated HER2-negative gastric/GEJ adenocarcinoma, published in JCO. Adding the anti-PD-L1/TGF-β bispecific antibody to first-line chemotherapy significantly improved overall and progression-free survival, supporting it as a potential new first-line standard.

Narrative review synthesizing retrospective data on ovarian metastases from colorectal cancer, published in JAMA Oncology (elite journal). Concludes ovaries act as a relative chemo-resistant sanctuary site, supporting a treatment approach combining systemic therapy with surgical resection to achieve complete clearance of disease.

Randomized phase 2 trial in pretreated HER2-positive advanced gastric/GEJ cancer testing addition of the novel CD47-blocking agent evorpacept to trastuzumab/ramucirumab/paclitaxel, published in Nature Medicine. Explores a new mechanism to enhance antibody-dependent phagocytosis, potentially informing future combination strategies in HER2+ gastric cancer.

Phase 1b/2 single-arm trial adding trastuzumab and nivolumab to first-line gemcitabine/cisplatin in HER2-positive advanced biliary tract cancer, published in Nature Medicine. Demonstrates a high response rate and disease control in a molecularly defined, hard-to-treat subgroup, supporting HER2-targeted chemoimmunotherapy as a potential new first-line strategy pending confirmatory trials.

Narrative review of contemporary and emerging treatment approaches in advanced cholangiocarcinoma, published in JCO Oncology Practice. Summarizes current standards (chemoimmunotherapy, targeted agents for FGFR2/IDH1/HER2) and future directions, useful for guiding sequencing of therapy.

Translational study in Journal for ImmunoTherapy of Cancer characterizing the NKG2A-HLA-E axis as part of an immunosuppressive checkpoint network in hepatocellular carcinoma, linking HLA-E expression to survival and to immunotherapy response, with combined NKG2A/PD-1 blockade tested in models. Suggests NKG2A blockade as a potential strategy to enhance checkpoint inhibitor efficacy in HCC.

Extended follow-up and biomarker subgroup analysis of a phase 2 trial arm in metastatic gastroesophageal cancer, published in European Journal of Cancer, evaluating FLOT plus nivolumab. Identifies PD-L1, neutrophil-to-lymphocyte, and monocyte-to-lymphocyte ratio as potential markers for identifying patients likely to benefit from triplet immunochemotherapy, informing patient selection for this intensive regimen.

Short perspective piece in Cancer Discovery (elite journal) discussing emerging RAS-targeting strategies for pancreatic cancer and their potential application to precancerous lesions for cancer interception. Conceptual overview rather than a practice-changing clinical dataset.

Single-arm phase 2 trial of trifluridine/tipiracil in fluoropyrimidine-refractory advanced pancreatic cancer with exploratory biomarker analysis, published in JCO Precision Oncology. Shows modest disease control and identifies candidate clinical/proteomic biomarkers of poor outcome, offering incremental data on a difficult-to-treat refractory population.

Translational analysis of tumor-infiltrating immune cell populations before and after preoperative chemoradiotherapy in locally advanced rectal cancer, published in JCO Precision Oncology. Identifies immune microenvironment features associated with pathologic response and survival, offering exploratory prognostic insight rather than an immediately actionable treatment-selection biomarker.

Post hoc analysis of the phase III CALGB/SWOG 80702 adjuvant colon cancer trial, published in JNCI, examining whether physical activity improves outcomes stratified by postoperative ctDNA status. Suggests physical activity benefits ctDNA-negative but not ctDNA-positive patients, offering a lifestyle-counseling nuance rather than a treatment change.

Commentary/critical appraisal in JNCI examining how trial design (NETTER-2 in NETs, CheckMate-743/KEYNOTE-483 in mesothelioma, MAGNITUDE in prostate cancer) shapes regulatory and clinical interpretation of benefit-risk. Offers no new efficacy data but informs how oncologists should critically interpret these pivotal trials.

Cohort study analyzing longitudinal quality-of-life and functional outcomes from a clinical trial of total neoadjuvant therapy in advanced rectal cancer, published in JAMA Network Open. Provides patient-reported outcome data that can inform counseling and treatment-sequencing discussions but doesn't change the therapeutic algorithm itself.