The third week of May brought together important updates across GI oncology, with 10 posts highlighting new research, expert perspectives, translational science, biomarker-driven strategies, and clinical discussions in colorectal, pancreatic, gastroesophageal, and liver cancers.
This week’s selection includes updates on ctDNA-guided risk assessment in colon cancer, evolving perioperative treatment strategies in gastro-oesophageal adenocarcinoma, a new single-cell transcriptomic pancreatic cancer dataset, surgical principles in rectal cancer, ctDNA dynamics ahead of ASCO in colorectal cancer, 5-year CheckMate 649 results, colorectal cancer management in older adults, long-term surveillance in pancreatic cysts, treatment tolerability in advanced GI malignancies, and emerging photoacoustic imaging tools for colorectal cancer.
Together, these posts reflect the breadth of current GI oncology research and practice, from early detection and molecular profiling to perioperative treatment advances, translational discoveries, geriatric oncology, surgical precision, and personalized treatment strategies across gastrointestinal cancers.
Henry Smith — Colorectal Fellow; Associate Professor at Bispebjerg Hospital, University of Copenhagen | Denmark
“Can ctDNA improve selection of patients with colon cancer to neoadjuvant chemotherapy?
Neoadjuvant therapy might improve outcomes in locally-advanced pMMR colon cancer but patient selection remains a major challenge. The use of clinical staging alone leads to overtreatment of >25% of patients and may also dilute the benefit of neoadjuvant treatment in patients with truly high risk disease.
In this study, we investigated whether pre-operative ctDNA levels were associated with high-risk features in patients with pMMR colon cancer and could potentially improve patient selection.
Patients with positive pre-operative ctDNA were:
• more likely to have advanced pathological stage
• more likely to have positive (R1) resection margins
• more likely to have early recurrences (<12 months of surgery)So while we can’t say pre-operative ctDNA can identify patients who will benefit from neoadjuvant therapy, it certainly seems to identify those with high-risk features. So should new trials of neoadjuvant chemotherapy include ctDNA assessment as an inclusion criteria?
A pleasure working with Tenna Henriksen and Claus Lindbjerg Andersen.”
Hongcheng Zhu — Physician, Radiation Oncologist at Fudan University Shanghai Cancer Center | China
“Delighted to share our new article published in Nature Reviews Clinical Oncology, Nature Portfolio, “Transforming perioperative treatment of gastro-oesophageal adenocarcinoma: triumphs, setbacks and future horizons.”
Gastro-oesophageal adenocarcinoma is entering a new era. Over the past decade, landmark trials have reshaped perioperative treatment strategies, redefining the roles of chemotherapy, radiotherapy, immune checkpoint inhibitors, targeted therapy, surgery and biomarker-guided decision-making.
In this Review, we bring together an international multidisciplinary team to synthesize the evolving evidence across East Asian and Western practice patterns, and to discuss how tumour biology, HER2-directed strategies, MSI-H/dMMR disease, circulating tumour DNA and organ-preserving approaches may shape the next generation of personalized perioperative care.
We are grateful to all co-authors for the outstanding contributions, Florian Lordick, MD, FESMO, Yelena Janjigian, Magnus Nilsson, Kohei Shitara, Richard Owen, Zhen Zhang & Elizabeth Smyth for the international effort.
This work reflects not only the rapid progress of gastro-oesophageal cancer treatment, but also the growing importance of global collaboration in translating evidence into better patient care.”
Nelson Dusetti — INSERM Research Director at CRCM and Paoli-Calmettes Institute; Pancreatic Cancer Researcher; Co-founder of Predicting Med | France
“We just published a single-cell transcriptomic dataset of 41 patient-derived pancreatic cancer cultures, more than 30,000 cells, publicly available.
This work comes from the pancreatic cancer team at CRCM – Centre de Recherche en Cancérologie de Marseille / Institut Paoli-Calmettes in Marseille, where translational research from patient samples to biological insight to clinical application is at the heart of what we do every day.
For many years, we have used these models as the foundation of our research: drug response profiling, transcriptomic signatures, metabolic studies.
Each time, we learned something new. Single-cell transcriptomics allowed us to go one step further. And what we found reminded us that in science, you never fully finish getting to know your models. The more closely you look, the more complexity you uncover.
What struck us most was the extent of transcriptional heterogeneity within cultures we had worked with for years and how much that changes the questions we now need to ask.
This “Behind the Paper” is my personal account of the reasoning, trade-offs and open questions behind this dataset.”
Reza Mirnezami — Consultant Colorectal, Robotic and Neuroendocrine Tumour Surgeon; Clinical Director of Colorectal and General Surgery at The Royal Free Hospital NHS Foundation Trust; NCL Cancer Alliance Network Director for Colorectal Cancer | United Kingdom
“Are we teaching TME as a technique… or as an oncological philosophy?
This paper is an important reminder that ‘total’ mesorectal excision was never meant to imply the same operation for every rectal cancer. Tailored mesorectal excision, MRI-guided planning, and surgical precision remain the core principles.
Essential reading for anyone involved in rectal cancer MDTs and pelvic surgery.”
Adham Jurdi — Oncology Diagnostics Strategy and Innovation; GI Oncology, MRD, Multi-Omics and AI Platforms | United States
“The IDEA collaboration has established the non-inferiority of 3 months of CAPOX in low-risk Stage III colorectal cancer (CRC) patients. However, significant caveats remain. Can Signatera ctDNA dynamics after 3 months of adjuvant chemotherapy guide decisions on who should receive an additional 3 months of adjuvant chemotherapy?
Additionally, what about MSI-H metastatic CRC on checkpoint inhibitors? Can Signatera dynamics during and after CPIs treatment inform our management strategies?
Join us for three insightful oral presentations next week at ASCO. Full list of Natera data being presented in the link below.
Benefit of adjuvant chemotherapy in resected stage I-IV CRC patients based on ctDNA dynamics across two timepoints: Results from GALAXY study.
Presenter: Mitsuru Yokota, MD, PhD
Date / Time: May 30, 2026, 8:00-9:00 AMPresentation Details: Oral Presentation – Clinical Science Symposium – ctDNA in Clinical Practice: From Detection to Clinical Decision-Making
Informing optimal duration of adjuvant chemotherapy (ACT) in resected stage I-IV colorectal cancer (CRC) based on early circulating tumor DNA (ctDNA) dynamics.
Presenter: Eiji Oki, MD, PhD, FACS
Date / Time: May 31, 2026, 8:00-11:00 AMPresentation Details: Oral Presentation – Oral Abstract Session – Gastrointestinal Cancer—Colorectal and Anal
Real-world outcomes and circulating tumor DNA (ctDNA) dynamics in patients with microsatellite instability–high (MSI-H) metastatic colorectal cancer (CRC) treated with immune checkpoint inhibitors (ICI).
Presenter: Hannah Ruth Robinson, MD
Date / Time: June 2, 2026, 8:00 AM – 9:30 AM”
Arndt Vogel — Head of the Center for Personalized Medicine, MHH at Medical University of Hanover | Germany
“Nivolumab plus chemotherapy as first-line treatment for advanced gastric, gastroesophageal junction, and esophageal adenocarcinoma: 5-year follow-up results from CheckMate 649
5-year OS 16% vs 6%
5-year PFS 10% vs 6%
Great to see more long-term OS.”
Read more about CheckMate 649 trial on OncoDaily.
Eric Van Cutsem — Medical Doctor and Professor of Medicine in Digestive Oncology at University Hospital Gasthuisberg/Leuven | Belgium
“On top of increasing challenges of Early Onset Colorectal Cancer, the management of elderly patients with CRC is equally important. Therefore read our new Expert Recommendation on the management of colorectal cancer in older patients, that we kicked off at the ESMO GI meeting.
The Lancet Gastroenterology & Hepatology shared:
Review | Management of colorectal cancer in older adults: expert recommendations for daily clinical practice
Colorectal cancer is predominantly a disease of older adults. Over the past decade, new treatment modalities and systemic therapeutic options have been introduced that have shaped and fundamentally redefined the treatment landscape for colorectal cancer. However, older patients remain under-represented in the clinical trials that shape treatment guidelines.
A new Review, led by Gabor Liposits and a distinguished panel of European oncology experts, explores how to translate evidence generated in younger, fitter trial populations to the older, frailer patients seen in clinic.”
Ilyas Sahin, MD — GI Medical Oncologist, Liver and GI Cancers, Clinical Trials and Novel Therapies at Massachusetts General Hospital and Harvard Medical School | United States
“Low-risk” pancreatic cysts are not truly no-risk.
New study in JAMA Network Open found patients with low-risk pancreatic cysts still had ~14-fold higher pancreatic cancer risk compared with the general population, and >25% of cancers occurred >5 years after initial cyst detection!
Early detection matters: 5-year survival for pancreatic cancer can improve from ~15% to ~80% when caught early. Long-term surveillance remains important.”
Tim Brown, MD MSCE — GI Medical Oncologist | United States
“New paper out now “Optimizing Systemic Therapy in Advanced Gastrointestinal Malignancies: Strategies to Minimize Toxicity and Maximize Tolerability” in Clinical Colorectal Cancer.”
Sanhita S. — Assistant Professor at Indian Institute of Science (IISc) | India
“New publication alert!
Excited to share our latest research and our first section of work towards an enzyme-responsive photoacoustic contrast agent for differentiating between an aggressive and a non-aggressive colorectal cancer model!
Key highlights:
• Small-molecule uPA responsive photoacoustic probe
• Probe generates a “TURN-OFF” signal upon activation
• Showed strong-specificity towards colorectal cancer cell lines with high uPA and cathepsin-activity (aggressive) vs. one with low-uPA and cathepsin activityNow published in Springer Nature npj Biomedical Innovations! Another stunning work led by Ananya Sharma, SUVAM KUMAR PANDA, Thuria and Sneha.
Colorectal cancer is complex and studying these two cell lines do not answer all the questions we had, and we continue to probe what other molecular markers along with uPA can aid in colorectal cancer, and especially small polyp diagnosis, in more sophisticated models!”
Lais Yuki Tuzino Kamia, M.S. — Incoming PhD Student; Clinical Dietitian; Researcher in Oncology Nutrition, Cancer Metabolism and Survivorship | Brazil
“I am thrilled to share that our scoping review, “Risk Factors for Hepatocellular Carcinoma in Latino Populations in Texas”, my very first paper, has been published in the International Journal of Molecular Sciences, Special Issue Liver Disease and Primary Liver Cancer: Translational Advances and Therapeutic Perspectives.
It examines the intersection of metabolic, environmental, and genetic risk factors contributing to severe health disparities.
This achievement would not have been possible without the guidance of Dr. Ramona Price and the dedicated efforts of an incredible team Emily Gonzalez, Cassandra Swanson, Stephanie Gomez and Ariann Canales.
It is my hope that this work brings much-needed attention to the specific risk factors affecting vulnerable and high-risk populations, ultimately driving culturally tailored prevention and better health outcomes.”
Find out 10 Must-Read Posts in GI Oncology from the second week of May on OncoDaily.