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Perioperative chemotherapy improved survival, with FLOT establishing a preferred regimen in locally advanced, non-metastatic disease, yet recurrence remains high. Building on checkpoint inhibitor success, MATTERHORN evaluated perioperative durvalumab with FLOT. In this journal issue, Long et al. report a phase 2 study assessing neoadjuvant cadonilimab plus FLOT and report promising pathologic response, alongside safety results in a multicenter Chinese cohort.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/right-place-right-time-editorial-commentary-the-role-of-immunotherapy-in-locally-advanced-gastricgastroesophageal-junction-adenocarcinoma/457232/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/right-place-right-time-editorial-commentary-the-role-of-immunotherapy-in-locally-advanced-gastricgastroesophageal-junction-adenocarcinoma/457232.png","ImageObject",300,407,{"name":92,"@type":93},"Bintang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is there an unmet need in locally advanced gastric/GEJ adenocarcinoma?","Question",{"text":112,"@type":113},"Even with established perioperative chemotherapy such as FLOT, recurrences remain high and 5-year survival is around 35%, indicating a need to improve outcomes, especially in non-metastatic patients.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What did the MATTERHORN study establish for perioperative immunotherapy?",{"text":117,"@type":113},"Adding durvalumab to FLOT met the primary event-free survival endpoint with a hazard ratio favoring the durvalumab arm and also improved median overall and disease-free survival, supporting a new chemo-immunotherapy standard of care.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the primary and key secondary endpoints in the reported cadonilimab phase 2 study?",{"text":121,"@type":113},"The primary endpoint was pathologic complete response (pCR). Secondary endpoints included major pathological response (MPR), overall response rate (ORR), disease control rate (DCR), R0 resection rate, downstaging rate, and safety.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},457232,1790948143,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962085564381,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Editorial Commentary  \nRight place right time: the role of immunotherapy in patients with locally advanced gastric/gastroesophageal junction adenocarcinoma  \nAbigail Fong1\\#, Dani Castillo2\\#, Pranati Shah3, Sophia Guzman1, Gagandeep Brar2  \n1Department of Surgical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA; 2Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA; 3Department of Internal Medicine, Loma Linda University, Loma Linda, CA, USA  \n\\#These authors contributed equally to this work.  \nCorrespondence to: Gagandeep Brar, MD. Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA. Email: [gbrar@coh.org](gbrar@coh.org).  \nComment on: Long B, Zhou H, Yu Z, et al. Neoadjuvant cadonilimab plus FLOT chemotherapy in locally advanced gastric/gastroesophageal junction  \nadenocarcinoma: A multicenter, phase 2 study. Med 2025;6:100531 .  \nKeywords: Gastric cancer; gastroesophageal cancer; immunotherapy  \nSubmitted Oct 15, 2025. Accepted for publication Nov 06, 2025. Published online Dec 23, 2025.  \ndoi: 10.21037/jgo-2025-aw-858  \nView this article at: [https://dx.doi.org/10.21037/jgo-2025-aw-858](https://dx.doi.org/10.21037/jgo-2025-aw-858)  \nCancers of the upper gastrointestinal tract (e.g. , gastric and gastroesophageal) are a leading cause of cancer related deaths worldwide. In 2025, the estimated new cases and deaths in the United States were approximately 52,370 and 27,030, respectively (1) . Although tumor characteristics and causative factors may be different depending on primary tumor location, adenocarcinomas of the gastric and gastroesophageal junction (GEJ) are oftentimes managed similarly (2) . In the locally advanced setting, the benefit of perioperative chemotherapy was first demonstrated in the landmark MAGIC trial (3) . This study compared epirubicin, cisplatin and fluorouracil (ECF) to surgery alone, and confirmed that perioperative chemotherapy improved progression-free survival and overall survival (OS) in patients with gastric/GEJ adenocarcinoma. More recently, ECF was compared to perioperative 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) in patients with locally advanced, non-metastatic gastric/GEJadenocarcinoma (4) . FLOT was found to be superior in achieving pathologic complete response (pCR), as well as OS. The toxicity profile was manageable and FLOT became the established perioperative chemotherapy regimen recommended for patients with locally advanced gastric or GEJ adenocarcinoma. However, recurrences remain high  \nwith a 5-year survival of approximately 35% . Therefore, an unmet need exists to improve patient outcomes, especially in the non-metastatic setting.  \nWith the success of checkpoint inhibitors in advanced stage patients, the MATTERHORN study explored the role of immunotherapy in the perioperative setting, where durvalumab, an anti-programmed cell death protein ligand 1 (PD-L1) inhibitor, was added to FLOT chemotherapy compared to placebo (5) . The interim analysis confirmed the primary endpoint of event-free survival (EFS) was met, resulting in a hazard ratio (HR) 0.71 favoring the durvalumab arm. Median OS (mOS) and median diseasefree survival (mDFS) were also improved, and there was an equal distribution of patients who were able to complete perioperative therapy without compromising surgical outcomes. Therefore, the MATTERHORN established a new standard of care with chemo-immunotherapy with durvalumab plus FLOT for patients with locally advanced gastric/GEJ adenocarcinoma patients.  \nIn this issue of the Journal of Gastrointestinal Oncology, Long et al. (6) reports the results of the ChiCTR2200066893 study, where the addition of cadonilimab to neoadjuvant chemotherapy was evaluated in patients with non-metastatic gastric/GEJ adenocarcinoma.  \n© AME Publishing Company. J Gastrointest Oncol 2025;16(6):2895-2899 ","cbCairAW4MF0mxgI","https://ap.wps.com/l/cbCairAW4MF0mxgI","pdf",179752,"English","# Editorial Commentary\n## Background: perioperative chemotherapy and unmet need\n## Checkpoint inhibition in the perioperative setting\n## Study reported in this issue: cadonilimab plus FLOT\n## Study design, endpoints, and key results","[{\"question\":\"Why is there an unmet need in locally advanced gastric/GEJ adenocarcinoma?\",\"answer\":\"Even with established perioperative chemotherapy such as FLOT, recurrences remain high and 5-year survival is around 35%, indicating a need to improve outcomes, especially in non-metastatic patients.\"},{\"question\":\"What did the MATTERHORN study establish for perioperative immunotherapy?\",\"answer\":\"Adding durvalumab to FLOT met the primary event-free survival endpoint with a hazard ratio favoring the durvalumab arm and also improved median overall and disease-free survival, supporting a new chemo-immunotherapy standard of care.\"},{\"question\":\"What were the primary and key secondary endpoints in the reported cadonilimab phase 2 study?\",\"answer\":\"The primary endpoint was pathologic complete response (pCR). Secondary endpoints included major pathological response (MPR), overall response rate (ORR), disease control rate (DCR), R0 resection rate, downstaging rate, and safety.\"}]","Right place right time - editorial commentary - the role of immunotherapy in locally advanced gastric/gastroesophageal junction adenocarcinoma | PDF",1790748669,13]