Advanced gastroesophageal cancer : recent advances in chemotherapy, targeted therapies, and immunotherapy

Since the 2020s, new therapeutic strategies have been validated, leading to significant practice changes in the management of advanced gastroesophageal adenocarcinomas. Trifluridine-tipiracil chemotherapy is an option from the third line since 2018. More recently, TFOX tri-chemotherapy has become a first-line standard for patients in good general condition. For adenocarcinomas overexpressing HER2, Trastuzumab-deruxtecan has been approved from the second line and is currently reimbursed from the third line onwards. Two phase III trials have recently demonstrated the benefit of Zolbetuximab combined with first-line chemotherapy for adenocarcinomas overexpressing Claudin 18.2. Lastly, anti-PD1 immunotherapy combined with first-line chemotherapy has become the standard treatment for gastroesophageal cancers overexpressing PD-L1, reflecting significant advances in combating this complex disease.