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BackTable Tumor Board

BackTable Tumor Board

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BackTable Tumor Board is a multi-disciplinary podcast for healthcare professionals that play an active role in cancer care.All rights reserved. Hygiene & gesundes Leben
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  • Ep. 86 Optimizing Treatment for Advanced HER2-Positive Upper GI Cancers with Dr. Geoffrey Buckle and Dr. Ronan Hsieh

    Ep. 86 Optimizing Treatment for Advanced HER2-Positive Upper GI Cancers with Dr. Geoffrey Buckle and Dr. Ronan Hsieh
    Oct 20 2026
    When a gastroesophageal tumor is positive for HER2, PD-L1, and claudin 18.2, which target should you treat first and how do you decide? On this episode of the BackTable GI Oncology Creator Weekend™, host Dr. Kate Baker interviews Dr. Geoffrey Buckle, a GI medical oncologist at UCSF, and Dr. Ronan Hsieh, a GI oncologist at Swedish Cancer Institute in Seattle, for a breakdown of therapy selection and management in advanced HER2-positive upper GI cancers. They start with a detailed case, covering biomarker workup, how to choose a first-line regimen without head-to-head data, and how to manage nutrition and palliative radiation when a patient presents with dysphagia and weight loss. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:41 - Case Presentation and Biomarker Workup05:07 - First-Line Treatment Selection11:27 - Oligoprogressive Disease and Local Therapy16:02 - HER2 Testing and Tumor Heterogeneity20:19 - ctDNA in Upper GI Cancers22:27 - HERIZON-GEA-01 and Zanidatamab27:18 - Triplet Versus Doublet and Diarrhea Management29:17 - Second-Line Therapy and Rebiopsy32:33 - Trastuzumab Deruxtecan and Interstitial Lung Disease36:33 - Later-Line Options and HER2-Low Disease39:17 - Future Directions and Closing Remarks --- More about this episode The conversation expands to interpreting equivocal HER2 results, tumor heterogeneity, and the importance of a second pathology review before committing to a treatment strategy. Dr. Hsieh explains how he approaches the HERIZON-GEA-01 trial data and the need to manage triplet therapy toxicity, especially diarrhea. The group discusses second-line rebiopsy to confirm HER2 status, the role of circulating tumor DNA (ctDNA), counseling and monitoring for interstitial lung disease on antibody-drug conjugates, and what to do for HER2 IHC 2+ FISH-negative tumors. They close with future directions, including trials moving HER2-directed therapies into earlier disease, the challenge of limited therapy lines, and why every line counts in this patient population. --- Resources Shitara K, et al. Zanidatamab with and without Tislelizumab in HER2-Positive Gastroesophageal Cancer (HERIZON-GEA-01). N Engl J Med. 2026https://pubmed.ncbi.nlm.nih.gov/42202319/ FDA approves zanidatamab-hrii and tislelizumab-jsgr for HER2-positive gastric, gastroesophageal junction and esophageal adenocarcinoma (August 2026)https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-zanidatamab-hrii-and-tislelizumab-jsgr-her2-positive-gastric-gastroesophageal-junction Pembrolizumab plus trastuzumab and chemotherapy for HER2-positive gastric or gastro-oesophageal junction adenocarcinoma: interim analyses from the phase 3 KEYNOTE-811 randomised placebo-controlled trial. Lancet. 2023https://pubmed.ncbi.nlm.nih.gov/37871604/ Trastuzumab in combination with chemotherapy versus chemotherapy alone for HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA). Lancet. 2010https://pubmed.ncbi.nlm.nih.gov/20728210/ Trastuzumab Deruxtecan in HER2-Low Gastric or Gastroesophageal Junction Adenocarcinoma: Exploratory Cohort Results in a Phase II Trial (DESTINY-Gastric01). J Clin Oncol. 2023https://pubmed.ncbi.nlm.nih.gov/36379002/ GEMINI-PeriOp GC: Novel Agents or Combinations as Perioperative Treatment in Locally Advanced Resectable Gastroesophageal Adenocarcinoma (trial record)https://clinicaltrials.gov/study/NCT07069712 Zolbetuximab plus CAPOX in CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 GLOW trial. Nat Med. 2023https://pubmed.ncbi.nlm.nih.gov/37524953/ Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer (MATTERHORN). N Engl J Med. 2025https://pubmed.ncbi.nlm.nih.gov/40454643/NCCN Clinical Practice Guidelines in Oncology: Gastric Cancer and Esophageal and Esophagogastric Junction Cancers (current versions)https://www.nccn.org/guidelines/category_1Dr. Geoffrey Buckle, UCSF Health physician profilehttps://www.ucsfhealth.org/providers/geoffrey-buckle Dr. Ronan Hsieh, Swedish physician profilehttps://www.swedish.org/doctors/medical-oncology/wa/seattle/ronan-hsieh-1457880031 Dr. Kate Baker, BackTable Tumor Board contributor pagehttps://www.backtable.com/shows/tumor-board/contributors/dr-kate-baker --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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    43 Min.
  • Ep. 85 Perioperative Management in Upper GI Cancers with Dr. Dani Castillo and Dr. Alexandra Gangi

    Ep. 85 Perioperative Management in Upper GI Cancers with Dr. Dani Castillo and Dr. Alexandra Gangi
    Oct 13 2026
    How do you choose between perioperative chemotherapy and trimodality therapy for a patient with localized upper GI cancer, and what has the newest data actually settled? On this episode of BackTable Tumor Board, host Dr. Kate Baker interviews Dr. Dani Castillo, a medical oncologist at City of Hope in Duarte, California, and Dr. Alexandra Gangi, a gastrointestinal surgical oncologist at Cedars-Sinai in Los Angeles, about everything that happens between a new diagnosis and a resection in localized esophageal, gastroesophageal junction and gastric cancer. They cover diagnostic workup, Siewert classification, staging laparoscopy, histology, biomarker testing, surgical candidacy, and the challenges of nutrition and prehabilitation. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:42 - Diagnostic Workup and Siewert Classification04:20 - Histology, Risk Stratification, and Biomarkers07:03 - Surgical Candidacy and Preoperative Optimization10:26 - Perioperative Chemotherapy versus Trimodality Therapy13:37 - Chemotherapy Tolerability, Immunotherapy, and Dose Reduction15:10 - Gastrectomy, Esophagectomy, and Recovery20:05 - Pathologic Response and Adjuvant Decisions21:55 - Organ Preservation and ctDNA24:54 - Future Directions and Ongoing Trials26:35 - Multidisciplinary Care and Community Practice27:40 - Closing Remarks --- More about this episode The conversation tackles the choice between perioperative chemotherapy and chemoradiation, when to add immunotherapy, and the latest data from ESOPEC and MATTERHORN. Dr. Gangi explains why subtotal versus total gastrectomy, anastomotic technique, and node dissection matter for recovery. The team discusses the role of organ preservation, ctDNA for de-escalation, and why multidisciplinary care remains essential even in smaller community practices. The episode closes with real-world strategies for managing frailty, dose reduction, and ensuring patients and providers are aligned before heading to the OR and why upper GI cancer stays a multidisciplinary disease even where the team is small. --- Resources Hoeppner J, et al. Perioperative Chemotherapy or Preoperative Chemoradiotherapy in Esophageal Cancer (ESOPEC). N Engl J Med. 2025https://pubmed.ncbi.nlm.nih.gov/39842010/ ESOPEC trial registry record (NCT02509286)https://clinicaltrials.gov/study/NCT02509286 Al-Batran SE, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin (FLOT4). Lancet. 2019https://pubmed.ncbi.nlm.nih.gov/30982686/ Perioperative durvalumab plus fluorouracil, leucovorin, oxaliplatin and docetaxel for resectable gastric and gastro-oesophageal junction adenocarcinoma (MATTERHORN). Lancet. 2026https://pubmed.ncbi.nlm.nih.gov/42716074/ MATTERHORN trial registry record (NCT04592913)https://clinicaltrials.gov/study/NCT04592913 Pembrolizumab Plus Chemotherapy Versus Chemotherapy as Perioperative Therapy in Locally Advanced Gastric and Gastroesophageal Junction Cancer: Final Analysis of KEYNOTE-585. J Clin Oncol. 2025https://pubmed.ncbi.nlm.nih.gov/40829093/ KEYNOTE-585 trial registry record (NCT03221426)https://clinicaltrials.gov/study/NCT03221426 Goodman KA, et al. Randomized Phase II Study of PET Response-Adapted Combined Modality Therapy for Esophageal Cancer: Mature Results of the CALGB 80803 (Alliance) Trial. J Clin Oncol. 2021https://pubmed.ncbi.nlm.nih.gov/34077237/ CALGB 80803 trial registry record (NCT01333033)https://clinicaltrials.gov/study/NCT01333033 Kelly RJ, et al. Adjuvant Nivolumab in Resected Esophageal or Gastroesophageal Junction Cancer (CheckMate 577). N Engl J Med. 2021https://pubmed.ncbi.nlm.nih.gov/33789008/ Cunningham D, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer (MAGIC). N Engl J Med. 2006https://pubmed.ncbi.nlm.nih.gov/16822992/ NCCN Guidelines Insights: Esophageal and Esophagogastric Junction Cancers, Version 4.2026. J Natl Compr Canc Netw. 2026https://pubmed.ncbi.nlm.nih.gov/42753809/ NCCN Clinical Practice Guidelines in Oncology, treatment by cancer typehttps://www.nccn.org/guidelines/category_1 Genomics of gastroesophageal junction adenocarcinomas and the Siewert classification. Transl Gastroenterol Hepatol. 2026https://pubmed.ncbi.nlm.nih.gov/42291157/ Dr. Dani Castillo, medical oncology, City of Hopehttps://www.cancercenter.com/physician-directory/dani-castillo Dr. Alexandra Gangi, Cedars-Sinai faculty profilehttps://researchers.cedars-sinai.edu/Alexandra.Gangi Dr. Alexandra Gangi, NANETS Board of Directors profilehttps://nanets.net/about/board-of-directors/450-gangi Dr. Kate Baker, BackTable contributor pagehttps://www.backtable.com/shows/tumor-board/contributors/dr-kate-baker --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free ...
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    30 Min.
  • Ep. 84 Managing Refractory MSS-MCRC: Advanced Treatment Strategies with Dr. Ibrahim Sahin and Dr. Sandra Algaze

    Ep. 84 Managing Refractory MSS-MCRC: Advanced Treatment Strategies with Dr. Ibrahim Sahin and Dr. Sandra Algaze
    Oct 6 2026
    What options remain when a patient with microsatellite stable metastatic colorectal cancer (MSS mCRC) has progressed through every standard line of chemotherapy? On this episode of BackTable Tumor Board, Dr. Jun Gong is joined by Dr. Ibrahim Sahin and Dr. Sandra Algaze to explore the nuances of late-line management in MSS-mCRC. They discuss how to approach oxaliplatin retreatment and anti-EGFR rechallenge, the growing role of liquid biopsy and biomarker-driven selection, and the practicalities of DPYD testing after recent guideline changes. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:55 - Oxaliplatin Retreatment and Anti-EGFR Rechallenge07:53 - DPYD Testing and Liquid Biopsy14:00 - Comparing Rechallenge and Conventional Agents15:42 - STELLAR-303 and Third-Line Options22:53 - Immunotherapy and MSS Biology25:42 - SUNLIGHT, FRESCO-2, and CORRECT Trials30:41 - Alternative Dosing Strategies32:02 - Botensilimab and Balstilimab Update37:06 - Neoadjuvant Immunotherapy38:15 - Emerging Antibody-Drug Conjugates 42:02 - Closing Remarks --- More about this episode The conversation walks through the latest clinical trial results for third-line and beyond, including strategies for dosing and tolerability, and the unique challenges posed by liver metastases. Drs. Sahin and Algaze highlight new developments in immunotherapy, antibody-drug conjugates, and bispecific antibodies, as well as the importance of matching therapy to both tumor biology and patient needs. They close with insights on patient monitoring, toxicity management, and the value of multidisciplinary care for this complex population. --- Resources STELLAR-303: Zanzalintinib Plus Atezolizumab Versus Regorafenib in Refractory Colorectal Cancer (The Lancet)https://pubmed.ncbi.nlm.nih.gov/41130252/ SUNLIGHT: Trifluridine-Tipiracil and Bevacizumab in Refractory Metastatic Colorectal Cancer (NEJM)https://www.nejm.org/doi/full/10.1056/NEJMoa2214963 FRESCO-2: Fruquintinib Versus Placebo in Refractory Metastatic Colorectal Cancer (The Lancet)https://www.thelancet.com/article/S0140-6736(23)00772-9/abstract CAPRI-2 GOIM: Liquid Biopsy Genomic Profiling to Predict FOLFIRI Plus Cetuximab Efficacy (ESMO Open)https://www.esmoopen.com/article/S2059-7029(25)00380-1/fulltext Botensilimab Plus Balstilimab in Relapsed/Refractory MSS Metastatic Colorectal Cancer (Nature Medicine)https://www.nature.com/articles/s41591-024-03083-7 Phase I Study of Telisotuzumab Adizutecan (ABBV-400), a c-Met Antibody-Drug Conjugate, in Late-Line Colorectal Cancer (JCO)https://ascopubs.org/doi/10.1200/JCO-25-01525 --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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    47 Min.
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