Jun Gong, MD

Articles by Jun Gong, MD

1 expert is featured in this series.

RATIONALE-305: Efficacy, Safety, and Real-World Applicability of Tislelizumab + Chemotherapy in Gastric/GEJ Adenocarcinoma

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion provides a focused summary of the RATIONALE-305 trial, which evaluated tislelizumab in combination with platinum-based chemotherapy as first-line treatment for patients with previously untreated, HER2-negative gastric or gastroesophageal junction (GEJ) adenocarcinoma. The discussion highlights the global, randomized design of the study and its key finding: adding tislelizumab to chemotherapy produced a statistically significant improvement in overall survival compared with chemotherapy alone. The benefit was observed in the intent-to-treat population and was greater in tumors expressing PD-L1 based on the trial’s predefined TAP scoring. Experts also note that the safety profile of the tislelizumab regimen was manageable and consistent with expectations for PD-1 inhibitors plus chemotherapy, with no new or unexpected toxicities reported. Overall, the segment underscores how the results of RATIONALE-305 support the role of tislelizumab-based therapy as an important emerging option in first-line treatment of advanced gastric or GEJ adenocarcinoma.

1 expert is featured in this series.

Mechanism of Action & Potential Impact of Tislelizumab

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion explores how tislelizumab’s unique Fc-region engineering may influence its activity in gastric cancer, particularly in patients with peritoneal metastases. Tislelizumab is designed to minimize binding to Fc-gamma receptors on macrophages, a modification intended to reduce macrophage-mediated clearance of activated T cells and help support a sustained anti-tumor immune response. This mechanism is scientifically relevant in the peritoneal cavity, where macrophages are abundant and can contribute to an immunosuppressive microenvironment. By limiting interaction with these cells, tislelizumab may offer a theoretical advantage in this difficult-to-treat subgroup. While this rationale is grounded in mechanistic biology, clinical validation is still needed to determine the extent of benefit in patients with peritoneal metastases. This segment highlights the scientific foundation behind tislelizumab’s design and its potential implications for addressing unmet needs in advanced gastric cancer.

1 expert is featured in this series.

Current Treatment Standards and Ongoing Challenges in Gastric Cancer

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion provides a clear overview of current treatment standards and ongoing challenges in the management of advanced gastric cancer. The discussion outlines how first-line therapy is anchored in HER2 status: patients with HER2-positive tumors receive HER2-targeted therapy combined with chemotherapy, while those with HER2-negative disease are treated with a PD-1 inhibitor plus platinum-based chemotherapy. PD-L1 expression, often measured using the combined positive score (CPS), helps refine decisions regarding the use of immunotherapy, with higher CPS values generally associated with greater benefit. The segment emphasizes the importance of obtaining HER2 and PD-L1 results early through comprehensive molecular profiling to guide individualized treatment selection. It also addresses one of the most difficult clinical issues in gastric cancer, peritoneal metastases, which are common, frequently hard to detect with imaging, and associated with poor outcomes. These factors highlight the complexity of caring for this population despite improvements in systemic therapy.

1 expert is featured in this series.

Standard of Care and Treatment Challenges in Gastric Cancer

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion provides an overview of current treatment standards and practical challenges in managing advanced gastric cancer. The discussion emphasizes that platinum–fluoropyrimidine doublet chemotherapy remains a widely used first-line backbone because it offers an effective balance of efficacy and tolerability. Experts also address ongoing debate around taxane-containing triplet regimens, noting that while certain regional studies have evaluated them, concerns about added toxicity and inconsistent benefit have limited their routine use in many practices. The segment highlights the importance of tailoring treatment to individual patient factors, including performance status, comorbidities, prior therapies, and patterns of spread such as peritoneal involvement or positive peritoneal cytology. It also reinforces that upfront surgery is generally not appropriate in stage IV disease and stresses the need for thorough staging and multidisciplinary coordination. Overall, this segment provides practical insights into evidence-based and individualized decision-making in advanced gastric cancer care.

1 expert is featured in this series.

Tislelizumab Mechanistic Rationale and Key Outcomes from RATIONALE-306 in ESCC

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion offers a focused examination of tislelizumab’s mechanism of action and the clinical data supporting its use in advanced esophageal squamous cell carcinoma (ESCC). Tislelizumab is distinguished by Fc-region engineering that minimizes binding to Fcγ receptors on macrophages, a feature intended to reduce the phagocytosis of activated T cells and help maintain a more sustained anti-tumor immune response. The segment then reviews the results of the global Phase 3 RATIONALE-306 trial, in which adding tislelizumab to platinum-based chemotherapy produced a statistically significant overall survival improvement compared with chemotherapy alone. The benefit was more pronounced in tumors expressing PD-L1, and survival advantages were observed across multiple clinically relevant subgroups. Safety findings were consistent with known profiles of PD-1 inhibitors, with no new or unexpected toxicities reported. Taken together, these mechanistic and clinical insights illustrate how tislelizumab has emerged as an important first-line immunotherapy option for patients with advanced ESCC.

1 expert is featured in this series.

Tislelizumab Mechanism and Data from RATIONALE-306 in ESCC

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion provides a detailed look at the mechanism and clinical evidence supporting tislelizumab in advanced esophageal squamous cell carcinoma (ESCC). The discussion explains that tislelizumab is engineered to minimize binding to Fc-gamma receptors on macrophages, a modification intended to reduce the phagocytosis of activated T cells and help sustain a more effective anti-tumor immune response. The segment then reviews key findings from the global Phase 3 RATIONALE-306 trial, in which adding tislelizumab to platinum-based chemotherapy resulted in a statistically significant overall survival improvement compared with chemotherapy alone. The survival advantage was observed in the intent-to-treat population and was greater in tumors expressing PD-L1, with benefit generally seen across the major clinical subgroups included in the study. The safety profile of the tislelizumab combination was consistent with expectations for PD-1 inhibitors plus chemotherapy, with no new or unexpected toxicities reported. Overall, the segment highlights how tislelizumab’s mechanism and clinical performance support its role as an important first-line immunotherapy option in advanced ESCC.

1 expert is featured in this series.

Review of Key Findings from CheckMate 648 and KEYNOTE-590

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion offers a focused review of two pivotal clinical trials, CheckMate 648 and KEYNOTE-590, that established the value of adding a PD-1 inhibitor to first-line platinum-based chemotherapy in advanced esophageal squamous cell carcinoma (ESCC). In CheckMate 648, nivolumab plus chemotherapy produced a meaningful overall survival improvement compared with chemotherapy alone, with the greatest benefit observed in patients whose tumors expressed PD-L1 (measured as tumor-cell ≥1%). Similarly, KEYNOTE-590 demonstrated that pembrolizumab combined with chemotherapy significantly prolonged overall survival versus chemotherapy alone, particularly in patients with PD-L1 CPS ≥1. Across both studies, median survival in the immunotherapy arms approached or exceeded the one-year mark, reinforcing the clinical impact of these combinations. Safety findings were consistent with known profiles of PD-1 inhibitors and cytotoxic therapy, with no unexpected signals. This segment highlights how these landmark trials have helped define chemo-immunotherapy as a key first-line standard in advanced ESCC.

1 expert is featured in this series.

Clinical Data from CheckMate 648 and KEYNOTE 590

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion provides a focused overview of the pivotal clinical trials that have defined the role of chemo-immunotherapy in the first-line treatment of advanced esophageal squamous cell carcinoma (ESCC). The discussion highlights results from CheckMate 648 and KEYNOTE-590, both of which demonstrated that adding a PD-1 inhibitor, nivolumab or pembrolizumab, to platinum-based chemotherapy leads to meaningful improvements in overall survival compared with chemotherapy alone. The magnitude of benefit was greater in patients whose tumors expressed PD-L1, consistent with the biomarker-driven findings reported in each study. The segment also notes that the chemotherapy backbones used in these global trials typically incorporated cisplatin, even though oxaliplatin-based regimens are more commonly used in U.S. clinical practice. Together, these data underscore how CheckMate 648 and KEYNOTE-590 established chemo-immunotherapy as an important first-line standard for advanced ESCC.

1 expert is featured in this series.

Choosing Chemotherapy With or Without Immunotherapy and the Use of PD-1 Inhibitors in ESCC

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion examines the key considerations oncologists weigh when choosing between chemotherapy alone or chemotherapy combined with a PD-1 inhibitor for patients with advanced esophageal squamous cell carcinoma (ESCC). The discussion focuses on how clinical judgment, practice patterns, and regional treatment norms influence decision-making, alongside the growing survival evidence supporting chemo-immunotherapy approaches. PD-L1 testing plays an increasingly important role in guiding these choices, with a CPS ≥1 threshold frequently used in clinical trials and real-world practice to help identify patients more likely to benefit from immunotherapy. Patient and tumor specific factors, such as disease burden, performance status, and comorbidities, are highlighted as central to personalizing treatment. The segment also emphasizes how guideline recommendations, including NCCN designations such as Category 1 for select regimens, shape standard practice and support treatment authorization. Together, these insights illustrate how clinicians integrate biomarkers, evidence, and guidelines to determine the most appropriate first-line approach for ESCC.

1 expert is featured in this series.

Selecting Chemotherapy ± Immunotherapy Regimens and the Role of PD-1 Inhibitors in ESCC

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion examines how clinicians decide between chemotherapy alone or chemotherapy combined with a PD-1 inhibitor in the first-line treatment of advanced esophageal squamous cell carcinoma (ESCC). The discussion emphasizes the relevance of PD-L1 expression in informing these choices, while noting that different clinical trials have used different PD-L1 assessment methods and thresholds, such as tumor-cell PD-L1 ≥1% or combined positive score (CPS)–based approaches, to help identify patients most likely to benefit from chemo-immunotherapy. Experts also review guideline-supported first-line options that incorporate PD-1 inhibitors such as nivolumab, pembrolizumab, or tislelizumab alongside platinum-based chemotherapy. Decisions about whether to add immunotherapy often depend on disease extent, PD-L1 expression level, patient comorbidities, and individual suitability for immunotherapy. Practical considerations, including institutional pathways and insurance requirements, may also influence regimen selection. Overall, the segment provides a realistic view of how clinicians integrate biomarkers, clinical evidence, and guidelines when personalizing first-line therapy for ESCC.

1 expert is featured in this series.

Current Treatment Standards and Diagnostic Approaches in Advanced ESC

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This segment offers an up-to-date overview of current treatment standards and diagnostic practices in advanced esophageal squamous cell carcinoma (ESCC). The discussion highlights how first-line therapy for advanced ESCC increasingly combines platinum-based chemotherapy with immunotherapy, specifically PD-1 inhibitors such as nivolumab, pembrolizumab, and tislelizumab. These regimens, supported by NCCN guideline recommendations, provide new hope for improved outcomes in this challenging disease. Additionally, the segment addresses the vital role of advanced diagnostics in guiding therapy. At the time of diagnosis, Next-Generation Sequencing (NGS) and molecular profiling, including assessment of PD-L1 and MSI status, are now standard practice. This approach ensures patients receive the most effective, personalized treatments. The segment underscores how these modern strategies combine cutting-edge drugs and genetic assessment to shape a dynamic era in ESCC care.

1 expert is featured in this series.

Overview of Standard of Care and Testing Approaches in Advanced ESCC

ByDavid H. Ilson, MD, PhD,Fadi Braiteh, MD ,Jun Gong, MD

This discussion provides an in-depth overview of the current standard of care for advanced esophageal squamous cell carcinoma (ESCC), with brief parallels to biomarker-driven gastric cancer management. Chemotherapy, most commonly fluoropyrimidine-based regimens combined with a platinum agent such as oxaliplatin or cisplatin, remains the treatment foundation, consistent with NCCN-endorsed approaches. The segment highlights the growing importance of molecular profiling, emphasizing next-generation sequencing (NGS) and immunohistochemistry for key biomarkers. In ESCC and related esophagogastric tumors, PD-L1 and mismatch repair/microsatellite instability status are central to immunotherapy decision-making, while in gastric and GEJ adenocarcinoma HER2 and claudin 18.2 have become critical targets. Experts underscore that timely biomarker testing, ideally completed before treatment initiation, guides selection of chemotherapy backbones, immunotherapy, and targeted agents, as contemporary guidelines increasingly advocate early, comprehensive evaluation. There is also mention of nuances in PD-L1 scoring (CPS vs TAP) and the need for standardized reporting across laboratories. This segment offers a practical framework for integrating testing into advanced ESCC care, with scalable lessons for gastric cancer.

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