Key GI Cancer Advances from the 2026 ASCO Symposium

This years 2026 ASCO Gastrointestinal Cancers Symposium was packed with practice-shaping data across colorectal and upper gastrointestinal malignancies, according to Dr. Suneel Kamath, who sat down for an interview with CURE following the meeting.

During the conversation, Kamath highlighted advances in biomarker-driven therapies, emerging frontline regimens, and early signals from prevention-focused research that may influence patient care in the near term. Additionally, he dives into more detail on these biomarker-driven updates in another video with CURE!

Currently, Kamath works as a gastrointestinal medical oncologist at Cleveland Clinic in Ohio and an assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.

CURE: From this year’s ASCO GI meeting, which data stood out as most likely to change clinical practice in the near term that patients should be aware of?

Kamath: It can certainly be overwhelming with all the news that comes out from these meetings all of a sudden, and there is a lot of hyperbole around many of these publications and abstract presentations. There were a couple that will affect practice in the very near future.

The first one is the phase 3 BREAKWATER trial. This was already presented and published last June at the ASCO Annual Meeting in 2025. What they presented at ASCO GI was the update for the FOLFIRI (folinic acid, fluorouracil, and irinotecan) chemotherapy backbone. Previously, it was FOLFOX with Braftovi (encorafenib) and Erbitux (cetuximab) combinations. This is for the BRAF V600E population in metastatic colorectal cancer.

This was really a true game changer. We use that term a lot in oncology, but this really made big waves last June because it was so much more effective than chemotherapy alone. This update was basically looking at that same BRAF-targeted regimen, Braftovi and Erbitux, but using FOLFIRI instead of FOLFOX as the chemotherapy backbone in the regimen. The good thing is that the early signal looks very similar in terms of strong efficacy, even though the chemotherapy regimen has been changed.

The advantage of that for patients is that the FOLFIRI regimen does not cause the neuropathy, the tingling and numbness in the hands and feet, that is a big problem with FOLFOX. It is nice to have this as another upfront option for patients because we can avoid that significant side effect of neuropathy, which really does affect people’s function and quality of life. Again, it emphasizes what we already heard before from this study. This is a disease state, this BRAF mutation in colorectal cancer, that we know overall has a very poor prognosis. Typically, it is very aggressive and very resistant to treatment.

Now, with this combination, we are actually seeing outcomes that are more similar to the regular, garden-variety type of colorectal cancer, and that truly is an advance for a population that had very poor outcomes before. So that is exciting to see, for sure.

What advances in upper gastrointestinal cancers were highlighted at the meeting?

Switching gears to the upper GI tract, to stomach and esophageal cancer, there was a presentation of the phase 3 HERIZON-GEA-01 trial. This was a randomized clinical trial in patients with HER2-amplified gastric or gastroesophageal junction cancer. It looked at this newer HER2-targeted drug, called Ziihera (zanidatamab-hrii), often shortened to “zani,” in combination with traditional chemotherapy, FOLFOX, with or without an immunotherapy drug called Tevimbra (tislelizumab-jsgr). If you are familiar with Keytruda (pembrolizumab), it is the same type of drug.

This was really exciting. We already have an existing combination of Herceptin (trastuzumab) and Keytruda with chemotherapy, so we saw this study as a potential next step. This was a positive study. The arm that included both Ziihera and the immunotherapy drug showed improved overall survival compared with chemotherapy and Herceptin alone. That difference was approximately seven months, which in upper GI cancer is truly significant. We do not usually see improvements of that magnitude, so that was very exciting to see. The results are still early and evolving over time, so we will see how the different arms change as more data emerge, but at least the early signal looks very positive.

This is a regimen that should receive FDA approval sometime in the next year and become available to us. It is great to have a new HER2-targeted therapy. We know this is an important driver in treatment, and having something that can target it more effectively than existing regimens is really exciting.

Were there any emerging prevention-focused findings that caught your attention?

One last study I will mention briefly may not change practice right away, but there was a database study looking at patients who took GLP-1 agonists. These are the medications like Mounjaro and Wegovy that many people are taking now. They examined whether these drugs had any benefit in preventing colorectal cancer, and there was a pretty significant benefit. This effect was actually greater than what we see with aspirin.

We know aspirin has been shown to help prevent polyp formation and reduce colorectal cancer recurrence, but it carries a bleeding risk, which is why it is not routinely recommended. The nice thing about GLP-1 drugs is that they are generally safe overall. They do have some side effects, but they also provide cardiovascular benefits. This really raises the possibility of using them more broadly, especially given that we are seeing so many younger people developing cancers, particularly colorectal cancer.

It made me think about whether these drugs could be explored in younger populations as a potential preventive strategy, since they are relatively safe and reduce the risk of heart attacks, strokes, and other serious health problems. It is an interesting potential prevention strategy in a younger population. I guess there was more coming out of this meeting than I initially thought. It was a really good one, as usual.

Transcript has been edited for clarity and conciseness.

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