Insights from ASCOGI25 by Udhayvir Grewal

The 2025 ASCO Gastrointestinal (GI) Cancers Symposium took place from Thursday, January 23 to Saturday, January 25.

This event featured the latest research, treatments, and strategies in the fight against GI cancers. People had the chance to attend expert-led sessions on emerging therapies, clinical breakthroughs, and multidisciplinary approaches to patient care.

For more details on the program, check out the official Meeting Announcement and download the full schedule.

Udhayvir Grewal, Resident Physician at Ochsner LSU Health Shreveport Academy Medical Centre, shared some insights from the conference.

Data from UI Holden Comprehensive Cancer Center on early onset SB-NETs

“Thank you Emil Lou and Shruti Patel MD for allowing me to share our data from UI Holden Comprehensive Cancer Center on early onset SB-NETs.

A growing problem of early onset GI cancers including GEPNENs. We need more research geared at understanding differences in biology, so we can make way for better and personalized therapies for our younger patients!”

Nivo monotherapy versus Combination Ipi/Nivolumab in advanced dMMR/MSI-H CRC

“CHECKMATE 8HW
Nivo monotherapy versus Combination Ipi/Nivolumab in advanced dMMR/MSI-H CRC.

New SOC for 1L therapy in advanced dMMR/MSI-H CRC.

Early and sustained separation of PFS curves.
2-year PFS 71% vs 56% favoring ipi+nivo.
ORR better with combo- 71% vs 58%
No new safety signals, GI25.

Now published in Lancet.”

New SOC for 1L MSS CRC with BRAF V600E mutation

“Woah! We have a new SOC for 1L MSS CRC with BRAF V600E mutation-BREAKWATER data presented by Dr. Kopetz.

EC+mFOLFOX vs SOC.

Significant improvement in ORR: 60% vs 40%.

12-month OS 79% vs 66%, median NR.

These are great results!

Recent FDA accelerated approval is right on the money.
New SOC!!! (without a doubt).”

Great discussion on updates in anal cancer by Cathy Eng.

“Great discussion on updates in anal cancer by Cathy Eng.

Anal cancer incidence rising, early stage most common. 5-year OS 36%.

Locally advanced anal cancer:

-No role for radiosensitizing chemo- RTOG98-11, ACTII
-5-FU-MMC remains SOC (cisplatin may be more appropriate in immunosupp patients , 5-FU in frail pts)
-no randomized data, but cape can be considered as an alternative to 5-FU, myelosupp may be an issue.
-IO in this setting-no role, ongoing studies.
-no role for adjuvant or maintenance therapy.

Advanced anal cancer:

-InterAACT: carbo-taxol became SOC due to similar ORR and better safety profile.
-POD1UM-303: Retifanlimab+carbo+taxol (compared to carbo+taxol) in metastatic treatment naive metastatic anal SCC: PFS improvement, ORR 56% trend for OS improvement. HIV + pts included. Now an NCCN 2B recommendation.
-EA2176: Carbo/taxol with or without Nivo- PFS primary endpoint, ctDNA incorporated. Finished enrolment. HIV+ patients included.”

Masterclass on management of colorectal neuroendocrine tumors

“Masterclass on management of colorectal neuroendocrine tumors (well-differentiated) by Jen Chan at GI25.

Rising incidence, primarily driven by rectal NETs.
Most CR NETs are non functional.
Grade, size and depth of invasion are some high risk features pre-resection.
EUS important for staging rectal NETs.

Localised rectal NETs:

-rectal NET/s <10 mm- endoscopic resection -10-20 mm: Multi-D discussion ->20 mm or LN+ rectal NETs- LAR or APR
-R1 resections are common, consider repeat EUS and multi-D discussion for residual disease management.

Advanced colorectal NETs:

-multi-D eval key!
-If SSTR+, start with SSA (a good test of biology)
-following progression- RLT, mTOR inh, TKIs. CAPTEM for G3
-can consider upfront RLT in Ki67 10-55% in select patients based on NETTER-2.”

Global phase 2 study presented by Dr. Fakih.

“Global phase 2 study presented by Dr. Fakih.

BOT/BAL combination compared to SOC (regirafenib or lonsurf) in pre-treated MSS CRC without liver metastases.

75 mg BOT/ 240 mg BAL q2wk with ORR 19%, DCR 55%. DOR and OS yet to mature.

Phase 3 planned! Great option for patients (a real unmet need) and promising signal for activity compared to existing SOC.”

Paradigm of NEN therapies

“In line with my NETs at GI25 agenda, I want to thank Oncology Brothers for covering the paradigm of NEN therapies at their fantastic event last night.

STARTER-NET doesn’t change practice but there’re a lot of newer and upcoming therapies and trials that will change how we treat NETs and give us better options to offer to our patients.”