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ASCO GI 2026 | Optimizing treatment with perioperative chemotherapy in gastric cancer
Marcel Verheij, MD, PhD, Radboud University Medical Centre, Nijmegen, Netherlands, highlights the current standard of perioperative chemotherapy in resectable gastric cancer and the importance of considering toxicity and tolerability when determining the best treatment approach for patients. Further studies are needed to identify subgroups of patients who benefit from specific therapies and to investigate whether intensification of pre-operative treatment can improve response rates and potentially eliminate the need for surgery in some cases. This interview took place at the 2026 American Society of Clinical Oncology Gastrointestinal Cancers Symposium in San Francisco, CA.
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Transcript
So perioperative chemotherapy is a current standard. And I think that toxicity and tolerability of the treatment should guide the best way of treating patients. For those patients who tolerate the chemotherapy poorly, you can consider providing a different approach, for example, chemoradiotherapy. But I guess that all new approaches should come from studies. So we need to do more studies to identify subgroups of patients who benefit from a certain therapy...
So perioperative chemotherapy is a current standard. And I think that toxicity and tolerability of the treatment should guide the best way of treating patients. For those patients who tolerate the chemotherapy poorly, you can consider providing a different approach, for example, chemoradiotherapy. But I guess that all new approaches should come from studies. So we need to do more studies to identify subgroups of patients who benefit from a certain therapy. If patients respond very well to pre-operative therapy, then the question is whether those patients really need post-operative treatment or whether surgery is sufficient for those patients. So I guess future directions in relation to Critics 2 will be investigating whether a further intensification of pre-operative treatment is possible and now in the era of immunotherapy it would be a logical step to evaluate whether we can incorporate immunotherapy in a pre-operative regimen in order to further increase the response rate to pre-operative treatment. And maybe certain patients don’t need surgery anymore if the treatment is so good that patients do not require surgery anymore.
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