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ESMO GI 2026 | HER2-targeted agents in metastatic esophagogastric cancer: challenges and opportunities
Kohei Shitara, MD, National Cancer Center Hospital East, Kashiwa, Japan, comments on emerging HER2-targeted agents in metastatic esophagogastric cancer. Dr Shitara details challenges targeting HER2 in esophagogastric cancer, with high intratumor heterogeneity, reduction in HER2 expression found following trastuzumab treatment and formation of a heterodimer between HER2 and EGFR which leads to incomplete HER2 blockade. In addition, activation of downstream pathways can promote drug resistance. There are many emerging therapies targeting HER2, including bispecific antibodies and new antibody-drug conjugates, and new combinations of existing agents with immunotherapy and HER2-targeted or downstream pathway inhibitors. In the future, better understanding of the tumor biology, stratification using biomarkers and reassessment of biology throughout the treatment period will also help improve patient outcomes. This interview took place at the European Society for Medical Oncology (ESMO) Gastrointestinal Cancer 2026 Congress in Munich, Germany.
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