Ahmet Dirican, Professor of Medical Oncology at Medicana International İzmir Hospital, shared a post on X:
“ASCO Guideline Update 2026: Advanced Gastroesophageal Cancer
A major shift toward biomarker-driven first-line therapy. What’s new?
- Mandatory early biomarker testing: PD-L1, MSI/dMMR, HER2, and now CLDN18.2
- CLDN18.2 enters routine practice → Zolbetuximab + chemotherapy for PD-L1 <1 disease
- PD-L1 ≥1 → Chemotherapy + immunotherapy (pembrolizumab, nivolumab, or tislelizumab)
- Dual positivity (PD-L1 + CLDN18.2) → Shared decision-making required
- Clarification on PD-L1 scoring (CPS vs TAP; concordant thresholds at 1%, 5%, 10%)
- Rapid pipeline evolution (e.g., zanidatamab in HER2+ disease may soon reshape guidance)
Advanced gastroesophageal cancer is no longer “chemotherapy-first.”
Treatment decisions now start with biomarkers.”
Title: Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update
Authors: Manish A. Shah, Erin B. Kennedy, Dana Deighton, Minaxi Jhawer, Kunal C. Kadakia, Sarbajit Mukherjee, Christopher Nevala-Plagemann, Anwaar Saeed, Bryan J. Schneider, Thomas Semrad, Kohei Shitara, Laura Tenner, Nataliya V. Uboha, Melani Vincelli, Davit Zohrabyan, Lakshmi Rajdev
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