Podcasts about gastroesophageal

Dr. Pedro Barata and Dr. Ugwuji Maduekwe discuss the evolving treatment landscape in gastroesophageal junction and gastric cancers, including the emergence of organ preservation as a selective therapeutic goal, as well as strategies to mitigate disparities in care. Dr. Maduekwe is the senior author of the article, "Organ Preservation for Gastroesophageal Junction and Gastric Cancers: Ready for Primetime?" in the 2026 ASCO Educational Book. TRANSCRIPT Dr. Pedro Barata: Hello, and welcome to By the Book, a podcast series from ASCO that features compelling perspectives from authors and editors of the ASCO Educational Book. I'm Dr. Pedro Barata. I'm a medical oncologist at University Hospitals Seidman Cancer Center and an associate professor of medicine at Case Western Reserve University in Cleveland, Ohio. I'm also the deputy editor of the ASCO Educational Book. Gastric and gastroesophageal cancers are the fifth most common cancer worldwide and the fourth leading cause of cancer-related mortality. Over the last decade, the treatment landscape has evolved tremendously, and today, organ preservation is emerging as an attainable but still selective therapeutic goal. Today, I'm delighted to be speaking with Dr. Ugwuji Maduekwe, an associate professor of surgery and the director of regional therapies in the Division of Surgical Oncology at the Medical College of Wisconsin. Dr. Maduekwe is also the last author of a fantastic paper in the 2026 ASCO Educational Book titled "Organ Preservation for Gastroesophageal Junction and Gastric Cancers: Ready for Prime Time?" We explore these questions in our conversations today.  Our full disclosures are available in the transcript of this episode as well. Welcome. Thank you for joining us today. Dr. Ugwuji Maduekwe: Thank you, Dr. Barata. I'm really, really glad to be here. Dr. Pedro Barata: There's been a lot of progress in the treatment of gastric and gastroesophageal cancers. But before we actually dive into some of the key take-home points from your paper, can you just walk us through how systemic therapy has emerged and actually allowed you to start thinking about a curative framework and really informing surgery decision-making? Dr. Ugwuji Maduekwe: Great, thank you. I'm really excited to be here and I love this topic because, I'm terrified to think of how long ago it was, but I remember in medical school, one of my formative experiences and why I got so interested in oncology was when the very first trials about imatinib were coming through, right? Looking at the effect, I remember so vividly having a lecture as a first-year or second-year medical student, and the professor saying, "This data about this particular kind of cancer is no longer accurate. They don't need bone marrow transplants anymore, they can just take a pill." And that just sounded insane. And we don't have that yet for GI malignancies. But part of what is the promise of precision oncology has always been to me that framework. That framework we have for people with CML who don't have a bone marrow transplant, they take a pill. For people with GIST. And so when we talk about gastric cancers and gastroesophageal cancers, I think the short answer is that systemic therapy has forced surgeons to rethink what "necessary" really means, right? We have the old age saying, "a chance to cut is a chance to cure." And when I started out, the conversation was simple. We diagnose the cancer, we take it out. Surgery's the default. But what's changed really over the last decade and really over the last five years is that systemic therapy has gotten good enough to do what is probably real curative work before we ever enter the operating room. So now when you see a patient whose tumor has essentially melted away on restaging, the question has to shift, right? It's no longer just, "Can I take this out?" It's "Has the biology already done the heavy lifting? Have we already given them systemic therapy, and can we prove it safely so that maybe we don't have to do what is a relatively morbid procedure?" And that shift is what has opened the door to organ preservation. Surgery doesn't disappear, but it becomes more discretionary. Necessary for the patients who need it, and within systems that can allow us to make sure that we're giving it to the right patients. Dr. Pedro Barata: Right, no, that makes total sense. And going back to the outcomes that you get with these systemic therapies, I mean, big efforts to find effective regimens or cocktails of therapies that allow us to go to what we call "complete response," right? Pathologic complete response, or clinical complete response, or even molecular complete response. We're having these conversations across different tumors, hematologic malignancies as well as solid tumors, right? I certainly have those conversations in the GU arena as well. So, when we think of pathologic CRs for GI malignancies, right? If I were to summarize the data, and please correct me if I'm wrong, because I'm not an expert in this area, the traditional perioperative chemo gives you pCRs, pathologic complete response, in the single digits. But then when you start getting smarter at identifying biologically distinct tumors such as microsatellite instability, for instance, now you start talking about pCRs over 50%. In other words, half of the patients' cancer goes away, it melts down by offering, in this case, immunotherapy as a backbone of that neoadjuvant. But first of all, this shift, right, from going from these traditional, "not smart" chemotherapy approaches to kind of biologically-driven approaches, and how important is pCR in the context of "Do I really need surgery afterwards?" Dr. Ugwuji Maduekwe: That's really the crux of the entire conversation, right? We can't proceed and we wouldn't be able to have the conversation about whether organ preservation is even plausible if we hadn't been seeing these rates of pathologic complete response. If there's no viable tumor left at resection, did surgery add something? Are we sure? The challenge before this was how frequently that happened. And then the next one is, as you've already raised, "Can we figure that out without operating?" In the traditional perioperative chemo era, pathologic complete response was relatively rare, like maybe one in twenty patients. When we go to more modern regimens like FLOT, it got closer to one in six. When you add immunotherapy in recent trials like MATTERHORN, it's nearly triple that rate. And it's worth noting here, I'm a health services-health disparities researcher, so we'll just pause here and note that those all sound great, but these landmark trials have significant representation gaps that limit and should inform how confidently we generalize these findings. But back to what you just said, right, the real inflection point is MSI-high disease where, with neoadjuvant dual-checkpoint blockade, trials like NEONIPIGAS and INFINITY show pCR rates that are approaching 50% to 60%. That's not incremental progress, that's a whole new different biological reality. What does that mean? If we're saying that 50% to 60% of the people we take to the OR at the time of surgery will end up having no viable tumor, man, did we need to do a really big surgery? But the problem right now is the gold standard, I think we would mostly agree, the gold standard is pathologic complete response, and we only know that after surgery. I currently tell my patients, right, because I don't want them to be like, "Wait, we did this whole thing." I'm like, "We're going to do this surgery, and my hope is that we're going to do the surgery and there will be no cancer left in your stomach after we take out your stomach." And they're like, "But we took out my stomach and you're saying it's a good thing that there's no cancer." And yes, right now that is true because it's a measure of the efficacy of their systemic therapy. It's a measure of the biology of the disease. But should we be acting on this non-operatively? To do that, we have to find a surrogate. And the surrogate that we have to figure out is complete clinical response. And that's where we have issues with the stomach. In esophageal cancer, the preSANO protocol, which we'll talk about a little bit, validated a structured clinical response evaluation. People got really high-quality endoscopies with bite-on biopsies. They got endoscopic ultrasounds. They got fine-needle aspirations and PET-CT, and adding all of those things together, the miss rate for substantial residual disease was about 10% to 15%. That's a number we can work with. In the stomach, it's a lot more difficult anatomically just given the shape of people's stomachs. There's fibrosis, there's ulceration. A fair number of stomach and GEJ cancers have diffuse histology which makes it difficult to localize and they also have submucosal spread. Those all conceal residual disease. I had a recent case where I scoped the patient during the case, and this person had had a 4 cm ulcer prior to surgery, and I scoped and there was nothing visible. And I was elated. And on the final pathology they had a 7 cm tumor still in place. It was just all submucosal. That's the problem. I'm not a gastroenterologist, but I would have said this was a great clinical response, but because it's gastric, there was a fair amount of submucosal disease that was still there. And our imaging loses accuracy after treatment. So the gap between what looks clean clinically and what's actually there pathologically remains very wide. So I think that's why we're trying to figure it out and make it cleaner. And outside of biomarker-selected settings like MSI-high disease, in general, I'm going to skip to the end and our upshot for the paper, which is that organ preservation, I would say for gastric cancer particularly, should remain investigational. I think we're at the point where the biology is increasingly favorable, but our means of measurement is not there yet. Dr. Pedro Barata: Gotcha. So, this is a perfect segue because you did mention the SANO, just to spell it out, "Surgery As Needed for Oesophageal" trial, so SANO, perfect, I love the abbreviation. It's really catchy. It's fantastic, it's actually a well-put-together perspective effort or program applying to patients. And can you tell us how was that put together and how does that work out for patients? Dr. Ugwuji Maduekwe: Yeah, I think for those of us in the GI space, we have SANO and then we also have the OPRA for rectum. SANO for the upper GI is what takes organ preservation from theory to something that's clinically credible. The trial asked a very simple question. If a patient with a GEJ adenocarcinoma or esophageal adenocarcinoma achieved what was felt to be a clinical complete response after chemoradiation, would they actually benefit from immediate surgery? And the question was, "Can you safely observe?" And the answer was 'yes'. You could safely observe, but only if you do it right. And what does that mean? At two years, survival with active surveillance was not inferior to those who received an immediate esophagectomy. And those patients had a better early quality of life. Makes sense, right? Your quality of life with an esophagectomy versus not is going to be different. That matters a lot when you consider what the long-term metabolic and functional consequences of an esophagectomy are. The weight loss, nutritional deficiencies that can persist for years. But SANO worked because it was very, very disciplined and not permissive. You mentioned rigor. They were very elegant in their approach and there was a fair amount of rigor. So there were two main principles. The first was that surveillance was front-loaded and intentional. So they had endoscopies with biopsies and imaging every three to four months in the first year and then they progressively spaced it out with explicit criteria for what constituted failure. And then salvage surgery was pre-planned. So, the return-to-surgery pathway was already rehearsed ahead of time. If disease reappeared, take the patient to the OR within weeks. Not sit, figure out what that means, think about it a little bit and debate next steps. They were very clear about what the plan was going to be. So they've given us this blueprint for, like, watching people safely. I think what's remarkable is that if you don't do that, if you don't have that infrastructure, then organ preservation isn't really careful. It's really hopeful. And that's what I really liked about the SANO trial, aside from, I agree, the name is pretty cool. Dr. Pedro Barata: Yeah, no, that's a fantastic point. And that description is spot on. I am thinking as we go through this, where can this be adopted, right? Because, not surprisingly, patients are telling you they're doing a lot better, right, when you don't get the esophagus out or the stomach out. I mean, that makes total sense. So the question is, you know, how do you see those issues related to the logistics, right? Getting the multi-disciplinary team, getting the different assessments of CR. I guess PETs, a lot of people are getting access to imaging these days. How close do you think this is, this kind of program, to be implemented? And maybe I would assume it might need to be validated in different settings, right, including the community. How close or how far do you think you see that being applied out there versus continuing to be a niche program, watch and wait program, in dedicated academic centers? Dr. Ugwuji Maduekwe: I love this question. So I said at the top of this, I'm a health equity/health disparities researcher, and this is where I worry the most. I love the science of this. I'm really excited about the science. I'm very optimistic. I don't think this is a question of "if," I think it's a question of "when." We are going to get to a point where these conversations will be very, very reasonable and will be options. One of the things I worry about is: who is it going to be an option for? Organ preservation is not just a treatment choice, and I think what you're pointing out very rightly is it's a systems-level intervention. Look at what we just said for SANO. Someone needs to be able to do advanced endoscopy, get the patients back. We have to have the time and space to come back every three to four months. We have to do molecular testing. There needs to be multi-disciplinary review. There needs to be intensive surveillance, and you need to have rapid access to salvage surgery. Where is that infrastructure? In this country, it's mostly in academic centers. I think about the panel we had at ASCO GI, which was fantastic. And as we were having the conversation, you know, we set it up as a debate. So folks were debating either pro-surveillance or pro-surgery. But both groups, both people, were presenting outcomes based on their centers. And it was folks who were fantastic. Dr. Molena, for example, from Memorial Sloan Kettering was talking about their outcomes in esophagectomies [during our session at GI26], but they do hundreds of these cases there per year. What's the reality in this country? 70% to 80% to 90%, depending on which data you look at, of the gastrectomies in the United States occur at low-volume hospitals. Most of the patients at those hospitals are disproportionately uninsured or on government insurance, have lower income and from racial and ethnic minority groups. So if we diffuse organ preservations without the system to support it, we're going to create a two-tiered system of care where whether you have the ability to preserve your organs, to preserve bodily integrity, depends on where you live and where you're treated. The other piece of this is the biomarker testing gap. One of the things that, as you pointed out at the beginning, that's really exciting is for MSI-high tumors. Those are the patients that are most likely to benefit from immunotherapy-based organ preservation. But here's the problem. If the patient isn't tested at time of initial diagnosis before they ever see me as a surgeon, the door to organ preservation is closed before it's ever open. And testing access remains very inconsistent across academic networks. And then there's the financial toxicity piece where, for gastrectomy, pancreatectomy, I do peritoneal malignancies, more than half of those patients experience significant financial toxicity related to their cancer treatment. We're now proposing adding at least two years, that's the preliminary information, right? It's probably going to be longer. At least a couple of years of surveillance visits, repeated endoscopies, immunotherapy costs. How are we going to support patients through that? We're going to have to think about setting up navigation support, geographic solutions, what financial counseling looks like. My patient for clinic yesterday was driving to see me, and they were talking about how they were sliding because it was snowing. And they were sliding for the entire three-hour drive down here. Are we going to tell people like that that they need to drive down to, right, I work at a high-volume center, they're going to need to come here every three months, come rain or snow, to get scoped as opposed to the one-time having a surgery and not needing to have the scopes as frequently? My concern, like I said, I'm an optimist, I think it is going to work. I think we're going to figure out how to make it work. I'm worried about whether when we deploy it, we widen the already existing disparities. Dr. Pedro Barata: Gotcha, and that's a fantastic summary. And as I'm thinking also of what we've been talking in other solid tumors, which one of the following do you think is going to evolve first? So we are starting to use more MRD-based assays, which are based on blood test, whether it's a tumor-informed ctDNA or non-informed. We are also trying to get around or trying to get more information response to systemic therapies out of RNA-seq through gene expression signatures, or development of novel therapeutics which also can help you there. Which one of these areas you think you're going to help this SANO-like approach move forward, or you actually think it's actually all of the above, which makes it even more complicated perhaps? Dr. Ugwuji Maduekwe: I think it's going to be all of the above for a couple of reasons. I would say if I had to pick just one right now, I think ctDNA is probably the most promising and potentially the missing piece that can help us close the gap between clinical and pathologic response. If you achieve clinical complete response and your ctDNA is negative, so you have clinical and molecular evidence of clearance, maybe that's a low-risk patient for surveillance. If you have clinical complete response but your ctDNA remains positive, I would say you have occult molecular disease and we probably need intensified therapy, closer monitoring, not observation. I think the INFINITY trial is already incorporating ctDNA into its algorithm, so we'll know. I don't think we're at the point where it alone can drive surgical decisions. I think it's going to be a good complement to clinical response evaluation, not a replacement. The issue of where I think it's probably going to be multi-dimensional is the evidence base: who are we testing? Like, what is the diversity, what is the ancestral diversity of these databases that we're using for all of these tests? How do we know that ctDNA levels and RNA-seq expression arrays are the same across different ancestral groups, across different disease types? So I think it's probably going to be an amalgam and we're going to have to figure out some sort of algorithm to help us define it based on the patient characteristics. Like, I think it's probably different, some of this stuff is going to be a little bit different depending on where in the stomach the cancer is. And it's going to be a little bit more difficult to figure out if you have a complete clinical response in the antrum and closer to the pylorus, for example. That might be a little bit more difficult. So maybe the threshold for defining what a clinical complete response needs to be is higher because the therapeutic approach there is not quite as onerous as for something at the GE-junction. Dr. Pedro Barata: Wonderful. And I'm sure AI, whether it's digitization of the pathology from the biopsies and putting all this together, probably might play a role as well in the future.  Dr. Maduekwe, it's been fantastic. Thank you so much for sharing your insights with us and also congrats again for the really well-done review published.  For our listeners, thank you for staying with us. Thank you for your time. We will post a link to this fantastic article we discussed today in the transcript of this episode. And of course, please join us again next month on the By the Book Podcast for more insights on key advances and innovations that are shaping modern oncology. Thank you, everyone. Dr. Ugwuji Maduekwe: Thank you. Thank you for having me. Watch the ASCO GI26 session: Organ Preservation for Gastroesophageal and Gastric Cancers: Ready for Primetime? Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:          Dr. Pedro Barata   @PBarataMD    Dr. Ugwuji Maduekwe @umaduekwemd Follow ASCO on social media:          @ASCO on X (formerly Twitter)          ASCO on Bluesky         ASCO on Facebook          ASCO on LinkedIn          Disclosures:       Dr. Pedro Barata:   Stock and Other Ownership Interests: Luminate Medical   Honoraria: UroToday   Consulting or Advisory Role: Bayer, BMS, Pfizer, EMD Serono, Eisai, Caris Life Sciences, AstraZeneca, Exelixis, AVEO, Merck, Ipson, Astellas Medivation, Novartis, Dendreon   Speakers' Bureau: AstraZeneca, Merck, Caris Life Sciences, Bayer, Pfizer/Astellas   Research Funding (Inst.): Exelixis, Blue Earth, AVEO, Pfizer, Merck    Dr. Ugwuji Maduekwe: Leadership: Medica Health Research Funding: Cigna    

Featuring perspectives from Dr Jaffer A Ajani, Dr Samuel J Klempner, Dr Rutika Mehta and Dr John Strickler, moderated by Dr Klempner, including the following topics:  Introduction (0:00) HER2-Targeted Approaches for Advanced Gastroesophageal Cancers — Dr Ajani (2:02) Faculty Panel Discussion: Cases and Questions from the Community (14:13) Targeting Claudin 18.2 in Advanced Gastroesophageal Cancers — Dr Strickler (37:29) Faculty Panel Discussion: Cases and Questions from the Community (49:21) Optimal Incorporation of Immunotherapeutic Strategies into Treatment for Patients with Metastatic Gastroesophageal Tumors — Dr Mehta (1:09:56) Faculty Panel Discussion: Cases and Questions from the Community (1:22:02) Other Novel Agents and Strategies Under Evaluation for Advanced Gastroesophageal Cancers — Dr Klempner (1:44:23) CME information and select publications

Dr Jaffer Ajani from The University of Texas MD Anderson Cancer Center in Houston, Dr Rutika Mehta from Weill Cornell Medicine/NewYork-Presbyterian Hospital in New York, New York, Dr John Strickler from Duke University in Durham, North Carolina, and Dr Samuel Klempner from Massachusetts General Hospital in Boston review relevant data supporting immunotherapy for patients with gastroesophageal cancers and review recently presented clinical findings from the 2026 ASCO Gastrointestinal Cancers Symposium.CME information and select publications here.

Dr Jaffer Ajani from The University of Texas MD Anderson Cancer Center in Houston, Dr Rutika Mehta from Weill Cornell Medicine/NewYork-Presbyterian Hospital in New York, New York, Dr John Strickler from Duke University in Durham, North Carolina, and Dr Samuel Klempner from Massachusetts General Hospital in Boston review relevant data supporting immunotherapy for patients with gastroesophageal cancers and review recently presented clinical findings from the 2026 ASCO Gastrointestinal Cancers Symposium.CME information and select publications here.

Guest: Daniela Molena, MD For patients with locally advanced gastroesophageal cancer, surgery remains a critical component of curative treatment—even in the era of chemoradiation and advanced imaging. Dr. Daniela Molena explores the challenges of assessing complete clinical response and the risks of non-operative management. Dr. Molena is an Associate Professor of Surgery at Weill Cornell Medicine and a Thoracic Surgeon at Memorial Sloan Kettering Cancer Center, and she discussed this topic at the 2026 ASCO Gastrointestinal Cancers Symposium.

Guest: Daniela Molena, MD For patients with locally advanced gastroesophageal cancer, surgery remains a critical component of curative treatment—even in the era of chemoradiation and advanced imaging. Dr. Daniela Molena explores the challenges of assessing complete clinical response and the risks of non-operative management. Dr. Molena is an Associate Professor of Surgery at Weill Cornell Medicine and a Thoracic Surgeon at Memorial Sloan Kettering Cancer Center, and she discussed this topic at the 2026 ASCO Gastrointestinal Cancers Symposium.

In this episode of SurgOnc Today's Surgical Oncology Insight series, Dr. Monisha Sudarshan, Section Editor of the Thoracic Editorial Board section, discusses with Dr. Erin A. Gillaspie her paper "Immunotherapy in gastroesophageal adenocarcinoma: What is the state of management?".

Featuring perspectives from Dr Yelena Y Janjigian, including the following topics: Introduction (0:00) Case: A man in his early 60s with a history of Barrett's esophagus presents with HER2-positive metastatic esophageal adenocarcinoma and a PD-L1 combined positive score (CPS) of 3 — Jennifer Yannucci, MD (10:20) Case: A man in his early 60s with multiregimen-recurrent HER2-positive gastroesophageal junction (GEJ) adenocarcinoma (claudin 18.2-positive, PD-L1 CPS 0) — Neil Morganstein, MD (14:53) Case: A woman in her early 80s with dementia and newly diagnosed mismatch repair-deficient, PD-L1-positive metastatic GEJ adenocarcinoma — Brian P Mulherin, MD (25:55) Case: A man in his mid 60s with localized HER2-negative GEJ cancer (PD-L1 CPS 2, claudin 18.2-positive) and residual disease after receiving neoadjuvant chemoradiation therapy and undergoing surgery — Stephen "Fred" Divers, MD (32:18) Case: A man in his early 80s with metastatic recurrence of esophageal adenocarcinoma and a PD-L1 total proportion score of 75% 2 years after resection of localized disease — Susmitha Apuri, MD (40:28) Case: A man in his mid 70s with claudin 18.2-positive metastatic esophageal adenocarcinoma who develops progressive toxicities with FOLFOX and zolbetuximab — Sean Warsch, MD (52:54) CME information and select publications

Dr Yelena Janjigian from Memorial Sloan Kettering Cancer Center in New York, New York, discusses updates across the treatment landscape for gastroesophageal cancers, as well as real-world clinical case examples.CME information and select publications here.

Dr Yelena Janjigian from Memorial Sloan Kettering Cancer Center in New York, New York, discusses updates across the treatment landscape for gastroesophageal cancers, as well as real-world clinical case examples.CME information and select publications here.

Dr Yelena Janjigian from Memorial Sloan Kettering Cancer Center in New York, New York, discusses updates across the treatment landscape for gastroesophageal cancers, as well as real-world clinical case examples.CME information and select publications here.

Featuring perspectives from Dr Manish A Shah, moderated by Dr Stephen "Fred" Divers, including the following topics:  Highlights and Principles of Management of Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma — Dr Shah (0:00) Case: A man in his early 50s with microsatellite instability-high localized esophageal adenocarcinoma — Dr Mulherin (15:24) Case: A woman in her late 60s with HER2-positive (IHC 3+) and HER2 TKD-mutant metastatic esophageal adenocarcinoma — Dr Warsch (25:34) Case: A woman in her early 70s with HER2-positive (IHC 3+), PD-L1-negative, CLDN18.2-negative metastatic gastric cancer — Dr Mulherin (28:15) Case: A woman in her early 70s with metastatic gastroesophageal junction adenocarcinoma (PD-L1 CPS 15) who begins treatment with FOLFOX/nivolumab and subsequently is found to have CLDN18.2 overexpression — Dr Lamar (35:23) Case: A man in his mid 40s with CLDN18.2-positive metastatic esophageal adenocarcinoma (PD-L1 10%) who receives mFOLFOX6 and zolbetuximab — Dr Yannucci (42:54) CE information and select publications

Dr Manish A Shah from Weill Cornell Medicine in New York, New York, summarizes the treatment landscape and reviews relevant clinical datasets for patients with gastroesophageal cancers. CME information and select publications here.

Dr Manish A Shah from Weill Cornell Medicine in New York, New York, summarizes the treatment landscape and reviews relevant clinical datasets for patients with gastroesophageal cancers. CME information and select publications here.

Dr Manish A Shah from Weill Cornell Medicine in New York, New York, summarizes the treatment landscape and reviews relevant clinical datasets for patients with gastroesophageal cancers. CME information and select publications here.

Learn which HER2-targeted therapies are being evaluated for the first-line treatment of gastroesophageal adenocarcinoma. Credit available for this activity expires: 11/27/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/her2-evolution-gastroesophageal-cancer-new-therapies-and-2025a1000x2t?ecd=bdc_podcast_libsyn_mscpedu

Are you ready for the evolving treatment paradigm in HER2-positive gastroesophageal adenocarcinoma (GEA) and biliary tract cancer (BTC)? Credit available for this activity expires: 10/24/27 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/her2-positive-gastroesophageal-adenocarcinoma-and-biliary-2025a1000sr3?&ecd=bdc_podcast_libsyn_mscpedu

In this podcast episode, Amit Mahipal, MD, MPH, and Shubham Pant, MD, discuss new and emerging therapies for the personalized care of patients with HER2-positive gastroesophageal adenocarcinoma (GEA) and biliary tract cancer (BTC), including:Brief overview of BTC and GEAApproved HER2-directed therapies for BTC and GEA and their mechanisms of actionEfficacy and toxicities of the approved agents and optimal management strategiesKey ongoing trials of HER2-directed therapies in BTC and GEAChallenges faced by healthcare professionals in the management of patients with BTC and/or GEA PresentersAmit Mahipal, MD, MPHDirector, Gastrointestinal Medical Oncology ProgramRuth and Donald Goodman Endowed Chair in GI OncologyProfessor of Medicine, Senior Attending PhysicianUniversity Hospitals Siedman Cancer CenterCase Comprehensive Cancer CenterCase Western Reserve UniversityCleveland, OhioShubham Pant, MDProfessorDepartment of Gastrointestinal (GI) Medical OncologyDepartment of Investigational Cancer TherapeuticsDirector of Clinical ResearchAssociate Director for Early Phase Drug DevelopmentSheikh Ahmed Bin Zayed Al Nahyan CenterMD Anderson Cancer CenterHouston, TexasLink to full program:https://bit.ly/3KL2ank Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Treatment Advances in Gastroesophageal Cancers with guest Dr. Raghav Sundar September 21, 2025 Yale Cancer Center visit: http://www.yalecancercenter.org email: canceranswers@yale.edu call: 203-785-4095

Treatment Advances in Gastroesophageal Cancers with guest Dr. Raghav Sundar September 21, 2025 Yale Cancer Center visit: http://www.yalecancercenter.org email: canceranswers@yale.edu call: 203-785-4095

Dr. Dipti Sagar discusses Gastroesophageal Reflux with Dr. Ben Weitz. [If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]   Podcast Highlights         ____________________________________________________________________ Dr. Dipti Sagar is an Integrative Gastroenterologist who practices in Century City as an associate of Dr. Farshid Rahbar and reflux is one of the many GI conditions that she treats regularly in patients. Her website is LAIntegrativeGI.com. Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

How confident are you navigating biomarker conversations with your gastric cancer patients? Credit available for this activity expires: 8/19/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002840?ecd=bdc_podcast_libsyn_mscpedu

Do you know why programmed death-ligand 1 (PD-L1) testing and targeted therapy are so important for improving patient care? Credit available for this activity expires: 6/27/26 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002597?ecd=bdc_podcast_libsyn_mscpedu

Featuring perspectives from Dr Geoffrey Y Ku and Dr Zev Wainberg, including the following topics: Introduction: ASCO Preview (0:00) HER2-Positive Gastroesophageal Cancers (19:03) Immunotherapy in HER2-Negative Advanced Gastroesophageal Cancers (36:11) Immunotherapy in Microsatellite Instability-High Gastroesophageal Cancers (44:04) CLDN18.2-Positive Advanced Gastroesophageal Cancers (51:30) CME information and select publications

Dr Geoffrey Y Ku from the Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Zev Wainberg from the UCLA School of Medicine discuss patient cases and summarize current treatment approaches for gastroesophageal cancer. CME information and select publications here.

Dr Geoffrey Y Ku from the Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Zev Wainberg from the UCLA School of Medicine discuss patient cases and summarize current treatment approaches for gastroesophageal cancer. CME information and select publications here.

Dr Geoffrey Y Ku from the Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Zev Wainberg from the UCLA School of Medicine discuss patient cases and summarize current treatment approaches for gastroesophageal cancer. CME information and select publications here.

Dr Sunnie Kim and Dr Manish Shah summarize the clinical treatment landscape for patients with gastroesophageal cancers, supported by clinical perspectives and management strategies from oncology nursing experts Ms Brooke Parker and Ms Michal Segal. NCPD information and select publications here.

Dr Sunnie Kim and Dr Manish Shah summarize the clinical treatment landscape for patients with gastroesophageal cancers, supported by clinical perspectives and management strategies from oncology nursing experts Ms Brooke Parker and Ms Michal Segal. NCPD information and select publications here.

Dr Sunnie Kim and Dr Manish Shah summarize the clinical treatment landscape for patients with gastroesophageal cancers, supported by clinical perspectives and management strategies from oncology nursing experts Ms Brooke Parker and Ms Michal Segal. NCPD information and select publications here.

Featuring perspectives from Dr Sunnie Kim, Ms Brooke Parker, Ms Michal Segal and Dr Manish Shah, including the following topics: Introduction: Clinical Presentation of Gastroesophageal Cancer (0:00) Management of Localized or Locally Advanced Gastroesophageal Cancers; Current and Future Role of Immune Checkpoint Inhibitors (21:44) Incorporation of Immunotherapeutic Strategies for HER2-Negative Metastatic Gastroesophageal Tumors (39:32) Role of Therapy Targeting CLDN18.2 in Advanced Gastric/Gastroesophageal Junction Adenocarcinoma (1:00:50) Considerations in the Care of Patients with HER2-Positive Gastroesophageal Cancers (1:22:41) NCPD information and select publications

Dr. Mindy answers questions about losing your voice, is it cold or is it allergies, toe fungus, Diabetic ketoacidosis, mouth taping, fused vertebrae, gout, decongestions during breast feeding, the Dr. Mindy Experiment, direct primary care, broken big toe, PCOS fertility naturally, carpal tunnel, genetic testing results, mounjaro, Gastroesophageal reflux disease, sitting on your hands and truck driver physicals. https://www.youtube.com/@TheDrMindyExperimentSee omnystudio.com/listener for privacy information.

Featuring perspectives from Dr Yelena Y Janjigian and Dr Samuel J Klempner, MD, including the following topics: Role of Immune Checkpoint Inhibitors in the Management of Gastroesophageal Cancers — Dr Janjigian (0:00) Available and Emerging Targeted Therapeutic Approaches for Gastroesophageal Cancers — Dr Klempner(28:38) CME information and select publications

Clinical investigators discuss available data guiding the management of gastroesophageal cancer.  CME information and select publications here.

Clinical investigators discuss available data guiding the management of gastroesophageal cancer.  CME information and select publications here.

Clinical investigators discuss available data guiding the management of gastroesophageal cancer.  CME information and select publications here.

Did you know that tumor area positivity (TAP) scoring can be completed up to 6 times faster than combined positive score (CPS)?   Credit available for this activity expires: 4/23/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002476?ecd=bdc_podcast_libsyn_mscpedu

Speaking of SurgOnc® has a new home! New episodes can now be found under the Society of Surgical Oncology's podcast, SurgOnc Today®, available on all major podcast platforms. Subscribe today to receive updates on new episode releases.  In this new episode of Speaking of SurgOnc®, Dr. Rick Greene discusses with Dr. Jeffrey Velotta the hypothesis that additional D2 dissection in Siewert II gastroesophageal junction cancer does not lead to increased survival and may not need to be routinely performed, as reported in their article, "The Impact of D2 Versus D1 Lymphadenectomy in Siewert II Gastroesophageal Junction (GEJ) Cancer."

Featuring perspectives from Dr Christopher Lieu, moderated by Dr Stephen “Fred” Divers CME information and select publications

Dr Christopher Lieu shares his perspectives on the evolving therapeutic landscape for patients with colorectal and gastroesophageal cancers, moderated by Dr Stephen "Fred" Divers. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/AON24).

Dr Christopher Lieu shares his perspectives on the evolving therapeutic landscape for patients with colorectal and gastroesophageal cancers.

Dr Christopher Lieu shares his perspectives on the evolving therapeutic landscape for patients with colorectal and gastroesophageal cancers.

Drs. Benjamin Schlechter and Harshabad Singh discuss toxicities in gastroesophageal cancer treatment; explore HER2+ in biliary tract tumors; and touch on the challenges of developing therapies targeting HER2+.

Drs. Benjamin Schlechter and Harshabad Singh explore the role and function of HER2 in gastrointestinal cancers, with a focus on gastroesophageal and colorectal cancers.

Gastroesophageal reflux disease (GERD), or heartburn, is incredibly common as is the use of stomach acid suppressing medication. But what if there is far more to the story than stomach acid? There are many other factors to consider in a patient with heartburn. We are going to dive into the physiology of gastric acid, gastric hormonal signaling, and a slew of medications and foods that might be the real culprit. Are PPI's over prescribed? Are we missing the picture? Tune in to find out. In today's episode, we tackle some burning questions about GERD and try to get to the root cause. Are acid suppressing medications always the answer? Perhaps the story is not that simple. Today on The Lab Report: 3:45 Conventional medicine's approach to GERD 6:30 The roll of the lower esophageal sphincter (LES) 8:15 Stomach acid and gastric hormonal signaling 13:20 Foods that affect the LES 14:15 PPI's - controversy and weaning 18:00 Prescriptive meds, lifestyle, and the LES 19:50 Hiatal hernias 21:30 Question of the Day How does hypochlorhydria or PPI use affect Genova testing? Additional Resources: Genova Connect **PROMO CODE TheLabReport20 for 20% off your purchase** Subscribe, Rate, & Review The Lab Report Thanks for tuning in to this week's episode of The Lab Report, presented by Genova Diagnostics, with your hosts Michael Chapman and Patti Devers. If you enjoyed this episode, please hit the subscribe button and give us a rating or leave a review. Don't forget to visit our website, like us on Facebook, follow us on Twitter, Instagram, and LinkedIn. Email Patti and Michael with your most interesting and pressing questions on functional medicine: podcast@gdx.net. And, be sure to share your favorite Lab Report episodes with your friends and colleagues on social media to help others learn more about Genova and all things related to functional medicine and specialty lab testing. To find a qualified healthcare provider to connect you with Genova testing, or to access select products directly yourself, visit Genova Connect. Disclaimer: The content and information shared in The Lab Report is for educational purposes only and should not be taken as medical advice. The views and opinions expressed in The Lab Report represent the opinions and views of Michael Chapman and Patti Devers and their guests.See omnystudio.com/listener for privacy information.

Did you miss the ESMO Congress 2024? Listen here: NEJM Editor-in-Chief Eric Rubin and NEJM Evidence Associate Editor Oladapo Yeku discuss research that was presented at the 2024 European Society of Medical Oncology annual meeting. Visit NEJM.org to read the latest research.

Featuring perspectives from Ms Deanna A Griffie, Ms Caroline Kuhlman, Dr Manish A Shah and Dr John Strickler, including the following topics: Introduction (0:00) The Current Role of Anti-PD-1/PD-L1 Antibodies in the Management of Nonmetastatic Gastroesophageal Cancers (11:30) The Potential Role of Immune Checkpoint Inhibitors (ICIs) as Neoadjuvant Therapy for Patients with Gastric/Gastroesophageal Junction Cancer (20:53) First-Line Therapy for Metastatic Gastroesophageal Cancers (36:16) The Potential Role of Therapy Targeting Claudin 18.2 for Gastroesophageal Cancers (42:16) Targeted Therapies for HER2-Positive Gastroesophageal Cancers (51:42) Selection of Appropriate Candidates with Localized Colorectal Cancer (CRC) for Adjuvant Therapy (1:14:24) The Current Role of ICIs in the Treatment of Metastatic CRC (mCRC) (1:23:32) Tolerability and Other Practical Considerations with ICIs (1:25:57) The Role of TAS-102/Bevacizumab in the Management of Relapsed/Refractory (R/R) mCRC (1:36:14) The Potential Role of KRAS-Targeted Therapy in the Management of mCRC (1:44:36) NCPD information and select publications

Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities.Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Wednesday at 7 AM.In this episode, Leah explores the relationship between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) in the context of veterans seeking disability compensation. Leah notes that while OSA is often linked to obesity, there is growing evidence of a connection to GERD. She emphasizes the importance of considering all risk factors, both positive and negative when evaluating a veteran's condition. Leah references various studies and articles that provide evidence of a link between OSA and GERD, highlighting how GERD might contribute to the development or severity of OSA. Throughout the video, she stresses the importance of having an objective, comprehensive medical opinion and encourages viewers to discuss these findings with their doctors to better understand the potential overlap between these conditions in their disability claims.Take control of your medical evidence related to your benefits and visit https://www.prestigeveteranmctx.com for more information and support.

Children can have a wide range of gastrointestinal disorders, and exams will require you to be able to differentiate between each one. In this episode, I'm providing a high level overview of common pediatric GI disorders: Gastroesophageal reflux disease Hirschsprung disease Intussusception Hypertrophic pyloric stenosis Biliary atresia Meckel's diverticulum Short bowel syndrome Plus, there's a PodQuiz at the end…so make sure you listen all the way through! ___________________ Full Transcript - Read the article and view references. FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! Study Sesh - If you liked the PodQuiz at the end of this episode, you'll LOVE Study Sesh! Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go.