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Advances in Frontline Gastric, GEJ, and Esophageal Adenocarcinoma From ESMO 2025

Advances in Frontline Gastric, GEJ, and Esophageal Adenocarcinoma From ESMO 2025

Yelena Y. Janjigian, MD, and Zev A. Wainberg, MD, provide a comprehensive overview of the evolving treatment landscape for advanced gastric, gastroesophageal junction (GEJ), and esophageal adenocarcinoma, highlighting current standards, unmet needs, and key clinical considerations. They review pivotal data from the EDGE-Gastric trial, discuss the design and potential impact of the phase 3 STAR-221 study, and explore where domvanalimab plus zimberelimab with chemotherapy could ultimately fit within the frontline paradigm. They also spotlight additional practice-informing findings from the 2025 ESMO Congress and outline ongoing research that may further refine therapeutic strategies in gastrointestinal oncology.

Advances in Frontline Gastric, GEJ, and Esophageal Adenocarcinoma From ESMO 2025

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2 experts are featured in this series.

Yelena Y. Janjigian, MD, and Zev A. Wainberg, MD, detail the design of the phase 3 STAR-221 trial comparing domvanalimab plus zimberelimab and FOLFOX with nivolumab plus chemotherapy for first-line advanced gastric, GEJ, or esophageal adenocarcinoma. They discuss why nivolumab plus chemotherapy serves as an appropriate control arm and the importance of head-to-head evidence in clarifying comparative benefit across immunotherapy combinations. They review the study’s primary endpoints and overall goals, including survival outcomes and the potential to redefine the frontline standard.