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ASCO 2026 | ARMANI: molecular profile & switch maintenance outcomes in HER2- G/GEJ cancer
Paolo Manca, MD, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, discusses the impact of molecular profiling on switch maintenance outcomes in the Phase III ARMANI trial (NCT02934464) in patients with HER2-negative gastric or gastroesophageal junction (G/GEJ) cancer. WNT pathway alterations demonstrated positive prognostic significance, while TP53 pathway status showed potential for guiding switch maintenance treatment selection. Homologous recombination deficiency positivity was not predictive of outcomes in either treatment arm. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
The ARMANI trial showed the benefit of switching first-line treatment strategy from oxaliplatin-based chemotherapy to paclitaxel-plus ramucirumab in patients with HER2-negative gastroesophageal adenocarcinoma. Using the molecular profile, we can try to select more carefully the patients to choose the ones that truly have a benefit from the strategy. As we show that in patients with TP53 wild-type tumors, the benefit of switching to maintenance to paclitaxel plus ramucirumab is higher compared to patients that have TP53 altered tumors...
The ARMANI trial showed the benefit of switching first-line treatment strategy from oxaliplatin-based chemotherapy to paclitaxel-plus ramucirumab in patients with HER2-negative gastroesophageal adenocarcinoma. Using the molecular profile, we can try to select more carefully the patients to choose the ones that truly have a benefit from the strategy. As we show that in patients with TP53 wild-type tumors, the benefit of switching to maintenance to paclitaxel plus ramucirumab is higher compared to patients that have TP53 altered tumors. This can be useful in trying to maximize the benefit of first-line treatment using a regimen which can be more toxic but can also bring a higher benefit to the patients.
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