Sam Klempner, MD

Panelists discuss the key takeaways, including the establishment of durvalumab plus FLOT as the new standard requiring proper laparoscopic staging and multidisciplinary care. Future questions focus on optimizing treatment for nonresponders and developing more personalized therapeutic approaches.

Panelists discuss how perioperative immunotherapy (IO) will serve as the foundation for future therapeutic advances, with potential directions including biomarker-driven personalized treatment, organ preservation strategies for complete responders, and integration of novel targeted therapies into the treatment paradigm.

Panelists discuss how successful implementation of durvalumab plus FLOT requires enhanced multidisciplinary coordination involving oncologists, surgeons, pharmacists, nurses, and nutritionists to optimize patient outcomes and manage the complexities of perioperative care.

Panelists discuss how adding durvalumab to FLOT does not significantly increase toxicity profiles and can be safely delivered using standard oncology practices with appropriate dose modifications, nutritional support, and multidisciplinary care coordination.

Panelists discuss how MATTERHORN establishes durvalumab plus FLOT as the new standard of care for all patients with resectable gastric cancers (GC) and gastroesophageal junction cancers (GEJC) who are candidates for curative-intent surgery, with plans to implement this regimen immediately upon regulatory approval.

Samuel J. Klempner, MD, discusses the safety and efficacy of givastomig plus nivolumab and chemotherapy in metastatic gastric cancers.

Panelists discuss how other immunotherapy trials in the perioperative setting, including studies with pembrolizumab and atezolizumab, have shown mixed results, with improved pathologic responses not necessarily translating to survival benefits. They note the negative results from the adjuvant CheckMate 577 trial.

Panelists discuss how adding immunotherapy (IO) to perioperative chemotherapy does not appear to complicate surgical procedures or compromise the ability to achieve negative margins, with R0 resection rates remaining unchanged between treatment arms in the MATTERHORN trial.

Panelists discuss how the MATTERHORN results represent a practice-changing advancement that they are ready to implement clinically, with improved pathologic complete response rates and event-free survival providing confidence in the regimen’s efficacy across most patient subgroups except those with microsatellite instability–high (MSI-H) tumors.

Panelists discuss how the MATTERHORN trial successfully demonstrated that adding durvalumab immunotherapy to perioperative FLOT chemotherapy significantly improved event-free survival with an 8-percentage point improvement at 24 months, representing a clear advancement in the treatment paradigm.

Panelists discuss how perioperative FLOT chemotherapy has simplified treatment decisions but presents toxicity challenges for patients with comorbidities, while emphasizing the critical importance of laparoscopic staging and acknowledging that current approaches still fail to cure approximately half of patients.

Panelists discuss how gastric cancers (GC) and gastroesophageal junction cancers (GEJC) present with nonspecific symptoms, affect approximately 1.2 million patients worldwide annually, and are managed with perioperative FLOT chemotherapy as the established standard of care for resectable disease.

Samuel J. Klempner, MD, discusses the FDA approval of zolbetuximab for CLDN18.2+, HER2–, locally advanced unresectable or metastatic gastric/GEJ adenocarcinoma.

Sam Klempner, MD, discusses the investigation of adagrasib in KRAS G12C–mutated metastatic colorectal cancer.

Sam Klempner, MD, discusses the incidence of KRAS G12C mutations in patients with metastatic colorectal cancer, the viability of the target in this disease, the efficacy of adagrasib in combination with cetuximab in this patient population, and the importance of genetic testing.