Neoadjuvant CTLA-4/PD-(L)1 Blockade Versus Surgery +/− Chemotherapy in Deficient Mismatch Repair/Microsatellite Instability–High Resectable Gastroesophageal Adenocarcinoma: Individual Patient Data Pooled Analysis
In resectable dMMR/MSI-H GEA, neoadjuvant ICIs significantly increase pathologic response and downstaging versus FLOT, with comparable EFS/OS with surgery with or without chemotherapy. The higher proportion of ypN0 and lack of ypT4 after neoadjuvant ICIs versus FLOT should drive preoperative treatment choices in clinical high-risk disease. The high proportion of pCR/MPR with ICIs provides rationale for exploring organ-sparing surgery or nonoperative management.
Authors
- Jae‐Ho Cheong (ORCID: https://orcid.org/0000-0002-1703-1781)
- Margherita Ambrosini (ORCID: https://orcid.org/0000-0003-4131-2409)
- Ferdinando De Vita (ORCID: https://orcid.org/0000-0002-7654-7470)
- Alessandra Raimondi (ORCID: https://orcid.org/0000-0002-8999-2899)
- Guillaume Piessen (ORCID: https://orcid.org/0000-0001-8243-8310)
- Roberta Fazio (ORCID: https://orcid.org/0009-0000-6690-2101)
- Jeeyun Lee (ORCID: https://orcid.org/0000-0002-4911-6165)
- Francesca Bergamo (ORCID: https://orcid.org/0000-0002-8795-4653)
- Alexej Ballhausen (ORCID: https://orcid.org/0000-0002-5470-4973)
- David Tougeron (ORCID: https://orcid.org/0000-0002-8065-9635)
- Paolo Manca (ORCID: https://orcid.org/0000-0002-3813-6339)
- Floriana Nappo (ORCID: https://orcid.org/0000-0002-1319-6052)
- Michele Prisciandaro (ORCID: https://orcid.org/0000-0001-5596-469X)
- Rosalba Miceli (ORCID: https://orcid.org/0000-0003-0954-375X)
- Sara Lonardi (ORCID: https://orcid.org/0000-0002-7593-8138)
- Dominik Paul Modest (ORCID: https://orcid.org/0000-0002-6853-0599)
- David Cunningham (ORCID: https://orcid.org/0000-0001-5158-1069)
- Matthew Nankivell (ORCID: https://orcid.org/0000-0003-3904-2729)
- Gabriele Tinè (ORCID: https://orcid.org/0000-0003-1762-1375)
- Gianmarco Ricagno
- Won Ki Kang (ORCID: https://orcid.org/0000-0002-0049-8086)
- Giovanni Randon (ORCID: https://orcid.org/0000-0003-0244-445X)
- Chiara Pircher (ORCID: https://orcid.org/0000-0001-8173-824X)
- Filippo Pietrantonio (ORCID: https://orcid.org/0000-0002-8530-8420)
- Thierry André (ORCID: https://orcid.org/0000-0002-5103-7095)
- Yoon Young Choi (ORCID: https://orcid.org/0000-0002-2179-7851)
- Elizabeth Smyth
Institutions
- Centre National de la Recherche Scientifique (FR)
- Royal Marsden NHS Foundation Trust (GB)
- University of Padua (IT)
- Inserm (FR)
- Yonsei University (KR)
- Soonchunhyang University (KR)
- Soonchunhyang University Hospital Seoul (KR)
- Samsung Medical Center (KR)
- Centre Hospitalier Universitaire de Lille (FR)
- Université de Poitiers (FR)
- Humboldt-Universität zu Berlin (DE)
- Sorbonne Université (FR)
- Hôpital Saint-Antoine (FR)
- Istituto Oncologico Veneto (IT)
- Royal Marsden Hospital (GB)
- University of Campania "Luigi Vanvitelli" (IT)
- Oxford BioMedica (United Kingdom) (GB)
- Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
- Onco Lille (FR)
- University College London (GB)
- Bucheon University (KR)
- Sungkyunkwan University (KR)
Publication Details
- Journal
- Journal of Clinical Oncology
- Published
- 2025-09-29
- DOI
- https://doi.org/10.1200/jco-25-00447
- Citations
- 4
- Primary Topic
- Gastric Cancer Management and Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 6.07