🍽️ GI Cancer — 2026-W41

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.

Randomized phase 2b trial adding an oncolytic adenovirus to first-line gemcitabine/nab-paclitaxel in metastatic pancreatic adenocarcinoma, published in Nature Medicine. Met its primary overall survival endpoint in the full analysis set, suggesting a potential new combination approach for first-line treatment.

Single-arm phase 2 trial in previously treated metastatic microsatellite-stable colorectal cancer, published in Clinical Cancer Research. Combining radiation with nivolumab/ipilimumab produced a modest response signal, mainly in patients without liver metastases, and was tolerable, but it remains hypothesis-generating.

Narrative review of pancreatic cancer cachexia pathophysiology and management, published in JCO Oncology Practice. Summarizes emerging cachexia-targeted therapies and nutritional assessment, helping oncologists recognize and manage an underdiagnosed problem.

Retrospective SEER-Medicare cohort study in JAMA Network Open comparing palliative care, systemic therapy, and hospice utilization between Medicare Advantage and Traditional Medicare patients with advanced breast, colorectal, lung, pancreatic, or prostate cancer. Highlights insurance-network-related disparities in supportive care access that could inform practice organization, though it does not change treatment selection directly.

Exploratory translational study of serial liquid biopsy and radiomics in biliary tract cancer on first-line systemic therapy, published in Clin Cancer Res. Suggests EGFR/MET copy-number changes mark resistance and worse outcomes, but it is hypothesis-generating and not yet practice-changing.

Multicenter retrospective matched cohort in HCC beyond Milan criteria undergoing liver transplant, published in JAMA Oncology. Informs whether ICI-based pretransplant downstaging is associated with posttransplant survival, recurrence and rejection outcomes, though retrospective design limits firm conclusions.

Population-based registry analysis with target trial emulation in metastatic esophagogastric adenocarcinoma, published in Eur J Cancer. Suggests deferring first-line systemic therapy in selected favourable patients does not clearly harm survival or quality of life, supporting discussion of deferral.

Trial design/protocol paper in Future Oncology describing the randomized phase II/III STELLAR-311 study comparing zanzalintinib to everolimus in advanced neuroendocrine tumors (pancreatic and extra-pancreatic, including lung). No efficacy results are reported yet, so it informs awareness of an ongoing trial rather than changing current practice.

Preclinical study in Cancer Discovery engineering a collagen-anchored IL-12-armed CAR-NK cell platform tested in ovarian and pancreatic cancer mouse models. Demonstrates improved NK cell persistence and tumor control, an early-stage concept with no clinical data yet.

Preclinical and translational study (mouse models plus human tumor specimens) published in Journal for ImmunoTherapy of Cancer identifying gut microbial bile-acid metabolites that enhance PD-1/SHP-2 signaling and immune suppression in colorectal cancer. Findings illuminate a mechanism of checkpoint-inhibitor resistance in MSS CRC but do not yet establish a validated predictive biomarker tied to patient outcomes.

Prospective cohort biomarker study in JAMA Network Open examining tumor vascular morphology (via multispectral immunofluorescence) and its association with colorectal cancer-specific mortality. Purely prognostic association without a specific therapy-selection implication.

Single-arm phase 2 pilot study combining pembrolizumab with PRRT in high-grade, somatostatin-receptor-avid metastatic neuroendocrine tumors, published in Clinical Cancer Research. Shows a modest response rate and manageable toxicity, suggesting possible synergy worth further randomized evaluation but not yet practice-changing.

Translational study in colorectal cancer using patient samples and MSI-H and MSS mouse models, published in J Immunother Cancer. Suggests propionate boosts CD8+ T-cell infiltration and anti-PD-L1 efficacy, a preclinical hypothesis that needs clinical testing.

Exploratory ctDNA analysis of the phase II CO.28 trial in node-negative rectal cancer after neoadjuvant chemotherapy and transanal excision, published in JCO Precision Oncology. Suggests post-chemotherapy ctDNA could help identify patients who need total mesorectal excision, though it needs further validation.

Large multicenter retrospective cohort of patients with HCC, published in JAMA Network Open, comparing mortality by sex. Provides prognostic context, but has no direct treatment implications.

Review of new treatments for gastric cancer, published in CA: A Cancer Journal for Clinicians. Highlights the challenge of selecting, combining and sequencing emerging therapies, useful as a practice-oriented update.