Final overall survival and the association of pathological outcomes with event-free survival in MATTERHORN: A randomised, phase 3 study of durvalumab plus 5-fluorouracil, leucovorin, oxaliplatin and docetaxel in resectable gastric / gastroesophageal junction adenocarcinoma

This Around the Practice program brings together a multidisciplinary panel to examine evolving perioperative strategies for resectable gastroesophageal and gastric cancers, with a particular focus on integrating systemic therapy, immunotherapy, and surgical planning. Panelists review emerging data from key studies, including the DFLOT regimen evaluated in the MATTERHORN trial, and discuss how these findings may influence real world care once regulatory decisions are finalized. Throughout the program, the experts highlight the importance of accurate staging, appropriate patient selection, and careful assessment of treatment tolerance when approaching complex early stage disease. The discussion incorporates practical considerations faced in both academic and community settings, including nutrition support, feeding access, performance status preservation, germline testing, and the coordination required for patients living at a distance from major centers. Two detailed patient cases illustrate decision making around PD L1 status, locally advanced tumor biology, and multidisciplinary management. The program concludes with reflections on future directions in biomarker driven perioperative therapy and the expanding role of collaborative care teams.