Transcript:
Kim: Unfortunately, at this time we don’t have a great alternative strategy in the adjuvant setting. There have been studies looking at whether different adjuvant therapies, like ipilimumab plus nivolumab, could work better in the era of FLOT alone, not necessarily FLOT plus durvalumab, and unfortunately we didn’t see a benefit.2 For patients who don’t have any pathological response after neoadjuvant FLOT plus durvalumab, I do continue FLOT on the back end with durvalumab, because sometimes we have patients who have clinical or radiologic improvements, and that’s to be considered as well as the pathological response. Of course, in the future, we need more effective strategies and treatments that can overcome resistance to FLOT plus durvalumab. My practice right now is to still offer the same treatment after surgery.
References
1. Janjigian YY, Al-Batran SE, Wainberg ZA, et al. Perioperative durvalumab in gastric and gastroesophageal junction cancer. N Engl J Med. 2025;393(3):217-230. doi:10.1056/NEJMoa2503701
2. Lordick F, Mauer ME, Stocker G, et al. Adjuvant immunotherapy in patients with resected gastric and oesophagogastric junction cancer following preoperative chemotherapy with high risk for recurrence (ypN+ and/or R1): European Organisation of Research and Treatment of Cancer (EORTC) 1707 VESTIGE study. Ann Oncol. 2025;36(2):197-207. doi:10.1016/j.annonc.2024.10.829