Interpretation of advances in the treatment of esophageal cancer and gastroesophageal junction cancer at the 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Jiahe ^1,2 , LU Jiayu ³ , ZHANG Xuxu ^1,2 , XU Xinyao ¹ , ZHANG Jipeng ¹ , LI Wei ¹ , LI Guizhen ¹ ,  LU Qiang ¹

1. Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, P. R. China;
2. Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, P. R. China;
3. Basic Medical College, Air Force Medical University, Xi'an, 710032, P. R. China;

Corresponding author：

LU Qiang, Email: luqiang@fmmu.edu.cn

Keywords：

Esophageal cancer; gastroesophageal junction cancer; advanced-stage treatment; perioperative treatment; interpretation

DOI：

10.7507/1007-4848.202504032

Video：

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The 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI) was held from January 23 to 25, 2025. Several significant studies on the treatment of esophageal and gastroesophageal junction (GEJ) cancer were presented at the symposium, highlighting notable advances, particularly in the perioperative and advanced settings. Immunotherapy has demonstrated significant promise in the neoadjuvant treatment of esophageal cancer, showing potential to become a standard treatment. Furthermore, the long-term survival benefits of combining immunotherapy with chemotherapy for advanced GEJ cancer were further validated. This article summarizes and interprets the researches presented at the symposium concerning perioperative and advanced treatments for esophageal and GEJ cancers.

Citation： LI Jiahe, LU Jiayu, ZHANG Xuxu, XU Xinyao, ZHANG Jipeng, LI Wei, LI Guizhen, LU Qiang. Interpretation of advances in the treatment of esophageal cancer and gastroesophageal junction cancer at the 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI). Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(6): 771-778. doi: 10.7507/1007-4848.202504032 Copy

1.	Morgan E, Soerjomataram I, Rumgay H, et al. The global landscape of esophageal squamous cell carcinoma and esophageal adenocarcinoma incidence and mortality in 2020 and projections to 2040: New estimates from GLOBOCAN 2020. Gastroenterology, 2022, 163(3): 649-658.
2.	Singh A. Global burden of five major types of gastrointestinal cancer. Prz Gastroenterol, 2024, 19(3): 236-254.
3.	Yan Y, Feng X, Li C, et al. Treatments for resectable esophageal cancer: From traditional systemic therapy to immunotherapy. Chin Med J (Engl), 2022, 135(18): 2143-2156.
4.	中国抗癌协会食管肿瘤整合康复专业委员会. 食管癌免疫检查点抑制剂临床应用全程管理专家共识. 中国医学前沿杂志 (电子版), 2024, 16(7): 1-21.China Anti-cancer Association Esophageal Tumor Integration Rehabilitation Prolessional Committee. Expert consensus on the whole-process management of clinical application of immune checkpoint inhibitors for esophageal cancer. Chin J Front Med Sci (Electr Ver), 2024, 16(7): 1-21.
5.	Leng X, He W, Lyu J, et al. Preliminary results from the multicenter, randomized phase Ⅲ trial (SCIENCE): Comparing chemotherapy plus sintilimab and chemoradiotherapy plus sintilimab versus chemoradiotherapy for neoadjuvant treatment in resectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4 suppl): LBA329.
6.	Dai L, Wu Y, Tian Z, et al. Perioperative adebrelimab combined with chemotherapy for locally advanced resectable esophageal squamous cell carcinoma: A single-arm, open-label, multicenter study. J Clin Oncol, 2025, 43(4 suppl): 421.
7.	Li Z, Yang Y, Liu Z, et al. Neoadjuvant adebrelimab plus chemotherapy for resectable locally advanced esophageal squamous cell carcinoma: A phase 2 trial. J Clin Oncol, 2025, 43(4 suppl): 443.
8.	Liu C, Huang W, Fu C, et al. Neoadjuvant SHR-1701 (a bifunctional anti-PD-L1/TGF-βRII agent) combined with chemoradiotherapy for resectable locally advanced esophageal squamous cell carcinoma (ESCC): A phaseⅡ trial. J Clin Oncol, 2025, 43(4 suppl): 410.
9.	Wang M, Dong W, Wu G, et al. Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage Ⅱ-Ⅳa esophageal cancer: A network meta-analysis. Syst Rev, 2025, 14(1): 26.
10.	Okui J, Nagashima K, Matsuda S, et al. Recurrence-free survival as a surrogate endpoint for overall survival after neoadjuvant chemotherapy and surgery for oesophageal squamous cell carcinoma. Br J Surg, 2024, 111(2): znae038.
11.	Cabrit N, Cheugoua-Zanetsie M, Tierney J, et al. Disease-free survival as surrogate for overall survival in esophageal cancer: An individual patient data meta-analysis of neoadjuvant chemotherapy and chemoradiotherapy. Eur J Cancer, 2025, 218: 115292.
12.	Okui J, Nagashima K, Matsuda S, et al. Surrogacy between pathological complete response and overall survival: An individual patient data analysis of eight RCTs on neoadjuvant treatment plus surgery for esophageal cancer. J Clin Oncol, 2025, 43(4 suppl): 498.
13.	Guo C, Li X, Chen S, et al. Anlotinib plus benmelstobart as adjuvant therapy in patients with esophageal squamous cell carcinoma: A phase Ⅱ clinical trial (ALTER-E005). J Clin Oncol, 2025, 43(4 suppl): 459.
14.	Chang ZW, Wang RR, Liu XL, et al. Anlotinib combined with penpulimab and nab-paclitaxel as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, open-label phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4 suppl): 367.
15.	Wang Y, Liu H, Wang Q, et al. Bifunctional anti-PD-L1/TGF-βRII agent SHR-1701 plus chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Survival results of a phase Ⅱ trial. J Clin Oncol, 2025, 43(4 suppl): 411.
16.	Xin D, Song Y, Mu L, et al. The efficacy and safety of nanoparticle albumin bound-paclitaxel-based regimen as second- or third-line treatment in patients with advanced esophageal squamous cell carcinoma. Thorac Cancer, 2023, 14(15): 1392-1397.
17.	Fukuoka S, Machida N, Mitani S, et al. Zimberelimab platform study: Safety and efficacy of zimberelimab in combination with futibatinib and chemotherapy in patients with first-line advanced or metastatic esophageal carcinoma. J Clin Oncol, 2025, 43(4 suppl): 409.
18.	Qu W, Gao J, Zhang B, et al. Efficacy, safety and DNA methylation analysis of cadonilimab combined with taxane and cisplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Updated results from an open-label, multicenter phaseⅡ trial (AK104-IIT-014). J Clin Oncol, 2025, 43(4 suppl): 463.
19.	Sano M, Yamamoto S, Shiraishi K, et al. The safety and short-term efficacy of induction DCF plus nivolumab therapy in patients with unresectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4 suppl): 425.
20.	Gu Y, Qiu T, Mingjie L, et al. Fruquintinib plus camrelizumab combined with paclitaxel liposome and nedaplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4 suppl): 445.
21.	Nie K, Han X, Zhang L, et al. Chemoimmunotherapy plus radiotherapy in advanced esophageal squamous-cell carcinoma. J Clin Oncol, 2025, 43(4 suppl): 437.
22.	Doki Y, Ajani JA, Kato K, et al. Nivolumab combination therapy in advanced esophageal squamous-cell carcinoma. N Engl J Med, 2022, 386(5): 449-462.
23.	Kojima T, Shah MA, Muro K, et al. Randomized phase Ⅲ KEYNOTE-181 study of pembrolizumab versus chemotherapy in advanced esophageal cancer. J Clin Oncol, 2020, 38(35): 4138-4148.
24.	Guo JC, Lin PS, Shau WY, et al. Does chemotherapy regimen matter for first-line immunochemotherapy in low programmed cell death ligand 1 (PD-L1)-expressing esophageal squamous cell carcinoma (ESCC)? A systemic review and meta-analysis. J Clin Oncol, 2025, 43(4 suppl): 395.
25.	Wu HX, Pan YQ, He Y, et al. Clinical benefit of first-line programmed death-1 antibody plus chemotherapy in low programmed cell death ligand 1-expressing esophageal squamous cell carcinoma: A post hoc analysis of JUPITER-06 and meta-analysis. J Clin Oncol, 2023, 41(9): 1735-1746.
26.	Wang X, Feng G, Fu C, et al. Preliminary results of the ALTER-E009 study: Efficacy and safety of anlotinib combined with radiotherapy in patients with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC): A multicenter, multi-cohort retrospective exploratory study. J Clin Oncol, 2025, 43(4 suppl): 361.
27.	Shen L, Bai Y, Lin X, et al. First-line (1L) nivolumab (NIVO) plus chemotherapy (chemo) vs chemo in patients (pts) with advanced gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up of Chinese pts from CheckMate 649. J Clin Oncol, 2025, 43(4 suppl): 392.
28.	Yen CJ, Oh DY, Bai Y, et al. Pembrolizumab or placebo plus chemotherapy for advanced HER2-negative gastric or gastroesophageal junction (G/GEJ) adenocarcinoma: An updated analysis of KEYNOTE-859 for patients enrolled in Asia. J Clin Oncol, 2025, 43(4 suppl): 464.
29.	Jia YX, Chang Z, Zhong YL, et al. Preliminary results of benmelstobart plus anlotinib combined with SOX in the first-line treatment of advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma with low PD-L1 expression: A single-arm, multicenter phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4 suppl): 444.
30.	Meng X, Shan Z, Guan L, et al. Updated results from the phaseⅠb/Ⅱstudy of fruquintinib combined with SOX and toripalimab in patients with advanced metastatic gastric/gastroesophageal junction adenocarcinoma (GC/GEJC). J Clin Oncol, 2025, 43(4 suppl): 423.
31.	Janjigian YY, Moehler MH, Ajani JA, et al. Nivolumab (NIVO) + chemotherapy (chemo) vs chemo as first-line (1L) treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up results from CheckMate 649. J Clin Oncol, 2025, 43(4 suppl): 398.

1. Morgan E, Soerjomataram I, Rumgay H, et al. The global landscape of esophageal squamous cell carcinoma and esophageal adenocarcinoma incidence and mortality in 2020 and projections to 2040: New estimates from GLOBOCAN 2020. Gastroenterology, 2022, 163(3): 649-658.
2. Singh A. Global burden of five major types of gastrointestinal cancer. Prz Gastroenterol, 2024, 19(3): 236-254.
3. Yan Y, Feng X, Li C, et al. Treatments for resectable esophageal cancer: From traditional systemic therapy to immunotherapy. Chin Med J (Engl), 2022, 135(18): 2143-2156.
4. 中国抗癌协会食管肿瘤整合康复专业委员会. 食管癌免疫检查点抑制剂临床应用全程管理专家共识. 中国医学前沿杂志 (电子版), 2024, 16(7): 1-21.China Anti-cancer Association Esophageal Tumor Integration Rehabilitation Prolessional Committee. Expert consensus on the whole-process management of clinical application of immune checkpoint inhibitors for esophageal cancer. Chin J Front Med Sci (Electr Ver), 2024, 16(7): 1-21.
5. Leng X, He W, Lyu J, et al. Preliminary results from the multicenter, randomized phase Ⅲ trial (SCIENCE): Comparing chemotherapy plus sintilimab and chemoradiotherapy plus sintilimab versus chemoradiotherapy for neoadjuvant treatment in resectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4 suppl): LBA329.
6. Dai L, Wu Y, Tian Z, et al. Perioperative adebrelimab combined with chemotherapy for locally advanced resectable esophageal squamous cell carcinoma: A single-arm, open-label, multicenter study. J Clin Oncol, 2025, 43(4 suppl): 421.
7. Li Z, Yang Y, Liu Z, et al. Neoadjuvant adebrelimab plus chemotherapy for resectable locally advanced esophageal squamous cell carcinoma: A phase 2 trial. J Clin Oncol, 2025, 43(4 suppl): 443.
8. Liu C, Huang W, Fu C, et al. Neoadjuvant SHR-1701 (a bifunctional anti-PD-L1/TGF-βRII agent) combined with chemoradiotherapy for resectable locally advanced esophageal squamous cell carcinoma (ESCC): A phaseⅡ trial. J Clin Oncol, 2025, 43(4 suppl): 410.
9. Wang M, Dong W, Wu G, et al. Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage Ⅱ-Ⅳa esophageal cancer: A network meta-analysis. Syst Rev, 2025, 14(1): 26.
10. Okui J, Nagashima K, Matsuda S, et al. Recurrence-free survival as a surrogate endpoint for overall survival after neoadjuvant chemotherapy and surgery for oesophageal squamous cell carcinoma. Br J Surg, 2024, 111(2): znae038.
11. Cabrit N, Cheugoua-Zanetsie M, Tierney J, et al. Disease-free survival as surrogate for overall survival in esophageal cancer: An individual patient data meta-analysis of neoadjuvant chemotherapy and chemoradiotherapy. Eur J Cancer, 2025, 218: 115292.
12. Okui J, Nagashima K, Matsuda S, et al. Surrogacy between pathological complete response and overall survival: An individual patient data analysis of eight RCTs on neoadjuvant treatment plus surgery for esophageal cancer. J Clin Oncol, 2025, 43(4 suppl): 498.
13. Guo C, Li X, Chen S, et al. Anlotinib plus benmelstobart as adjuvant therapy in patients with esophageal squamous cell carcinoma: A phase Ⅱ clinical trial (ALTER-E005). J Clin Oncol, 2025, 43(4 suppl): 459.
14. Chang ZW, Wang RR, Liu XL, et al. Anlotinib combined with penpulimab and nab-paclitaxel as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, open-label phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4 suppl): 367.
15. Wang Y, Liu H, Wang Q, et al. Bifunctional anti-PD-L1/TGF-βRII agent SHR-1701 plus chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Survival results of a phase Ⅱ trial. J Clin Oncol, 2025, 43(4 suppl): 411.
16. Xin D, Song Y, Mu L, et al. The efficacy and safety of nanoparticle albumin bound-paclitaxel-based regimen as second- or third-line treatment in patients with advanced esophageal squamous cell carcinoma. Thorac Cancer, 2023, 14(15): 1392-1397.
17. Fukuoka S, Machida N, Mitani S, et al. Zimberelimab platform study: Safety and efficacy of zimberelimab in combination with futibatinib and chemotherapy in patients with first-line advanced or metastatic esophageal carcinoma. J Clin Oncol, 2025, 43(4 suppl): 409.
18. Qu W, Gao J, Zhang B, et al. Efficacy, safety and DNA methylation analysis of cadonilimab combined with taxane and cisplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Updated results from an open-label, multicenter phaseⅡ trial (AK104-IIT-014). J Clin Oncol, 2025, 43(4 suppl): 463.
19. Sano M, Yamamoto S, Shiraishi K, et al. The safety and short-term efficacy of induction DCF plus nivolumab therapy in patients with unresectable locally advanced esophageal squamous cell carcinoma. J Clin Oncol, 2025, 43(4 suppl): 425.
20. Gu Y, Qiu T, Mingjie L, et al. Fruquintinib plus camrelizumab combined with paclitaxel liposome and nedaplatin as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): A single-arm, phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4 suppl): 445.
21. Nie K, Han X, Zhang L, et al. Chemoimmunotherapy plus radiotherapy in advanced esophageal squamous-cell carcinoma. J Clin Oncol, 2025, 43(4 suppl): 437.
22. Doki Y, Ajani JA, Kato K, et al. Nivolumab combination therapy in advanced esophageal squamous-cell carcinoma. N Engl J Med, 2022, 386(5): 449-462.
23. Kojima T, Shah MA, Muro K, et al. Randomized phase Ⅲ KEYNOTE-181 study of pembrolizumab versus chemotherapy in advanced esophageal cancer. J Clin Oncol, 2020, 38(35): 4138-4148.
24. Guo JC, Lin PS, Shau WY, et al. Does chemotherapy regimen matter for first-line immunochemotherapy in low programmed cell death ligand 1 (PD-L1)-expressing esophageal squamous cell carcinoma (ESCC)? A systemic review and meta-analysis. J Clin Oncol, 2025, 43(4 suppl): 395.
25. Wu HX, Pan YQ, He Y, et al. Clinical benefit of first-line programmed death-1 antibody plus chemotherapy in low programmed cell death ligand 1-expressing esophageal squamous cell carcinoma: A post hoc analysis of JUPITER-06 and meta-analysis. J Clin Oncol, 2023, 41(9): 1735-1746.
26. Wang X, Feng G, Fu C, et al. Preliminary results of the ALTER-E009 study: Efficacy and safety of anlotinib combined with radiotherapy in patients with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC): A multicenter, multi-cohort retrospective exploratory study. J Clin Oncol, 2025, 43(4 suppl): 361.
27. Shen L, Bai Y, Lin X, et al. First-line (1L) nivolumab (NIVO) plus chemotherapy (chemo) vs chemo in patients (pts) with advanced gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up of Chinese pts from CheckMate 649. J Clin Oncol, 2025, 43(4 suppl): 392.
28. Yen CJ, Oh DY, Bai Y, et al. Pembrolizumab or placebo plus chemotherapy for advanced HER2-negative gastric or gastroesophageal junction (G/GEJ) adenocarcinoma: An updated analysis of KEYNOTE-859 for patients enrolled in Asia. J Clin Oncol, 2025, 43(4 suppl): 464.
29. Jia YX, Chang Z, Zhong YL, et al. Preliminary results of benmelstobart plus anlotinib combined with SOX in the first-line treatment of advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma with low PD-L1 expression: A single-arm, multicenter phase Ⅱ clinical trial. J Clin Oncol, 2025, 43(4 suppl): 444.
30. Meng X, Shan Z, Guan L, et al. Updated results from the phaseⅠb/Ⅱstudy of fruquintinib combined with SOX and toripalimab in patients with advanced metastatic gastric/gastroesophageal junction adenocarcinoma (GC/GEJC). J Clin Oncol, 2025, 43(4 suppl): 423.
31. Janjigian YY, Moehler MH, Ajani JA, et al. Nivolumab (NIVO) + chemotherapy (chemo) vs chemo as first-line (1L) treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC): 5-year (y) follow-up results from CheckMate 649. J Clin Oncol, 2025, 43(4 suppl): 398.

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Interpretation of advances in the treatment of esophageal cancer and gastroesophageal junction cancer at the 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI)

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