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Review
. 2025 Sep;27(9):3580-3594.
doi: 10.1007/s12094-025-03865-6. Epub 2025 Mar 12.

Biomarkers in gastroesophageal cancer 2025: an updated consensus statement by the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP)

Maria Alsina Maqueda  1 , Ana Teijo Quintáns  2 , Miriam Cuatrecasas  3 , Maria Jesús Fernández Aceñero  4   5 , Ana Fernández Montes  6 , Carlos Gómez Martín  7 , Paula Jiménez Fonseca  8 , Carolina Martínez Ciarpaglini  9 , Fernando Rivera Herrero  10 , Mar Iglesias Coma  11
Affiliations
Review

Biomarkers in gastroesophageal cancer 2025: an updated consensus statement by the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP)

Maria Alsina Maqueda et al. Clin Transl Oncol. 2025 Sep.

Erratum in

Abstract

Gastroesophageal carcinomas, including gastroesophageal adenocarcinoma (GEA) and esophageal squamous cell carcinoma (ESCC), pose a global health challenge due to their heterogeneity. The approach to diagnosis and treatment should first differentiate between GEA and ESCC. Over the past decade, therapies for metastatic or advanced GEA/ESCC have expanded, with several new therapeutic targets alongside trastuzumab for metastatic HER2-positive GEA. Four key biomarkers are essential for targeted therapy: HER2 overexpression/amplification, deficient mismatch repair/microsatellite instability (dMMR/MSI), PD-L1, and Claudin18.2 expression. Immunohistochemistry is the recommended method for these biomarkers evaluation. In addition, the assessment of biomarkers like FGFR2b is likely to become routine in the near future. Experts from the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM) have formed a consensus to optimize biomarker detection and usage in clinical practice. Their recommendations aim to improve personalized treatment strategies for GEA and ESCC patients, integrating new diagnostic insights into routine care.

Keywords: Biomarkers; Claudin 18.2; Gastroesophageal carcinoma; HER2; MSI/dMMR; PD-L1.

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Conflict of interest statement

Declarations. Conflict of interest: AMM has participated in consulting and/or advisory boards for Amgen, AstraZeneca, BeiGene, Jazz Pharmaceuticals, BMS, Novartis and MSD. Speaker honoraria from Astellas, Beigene, Jazz Pharmaceuticals. ICM has participated in consulting and/or advisory boards for BeiGene, BMS, Astellas, Roche, Gilead, AstraZeneca, and MSD. Speaker honoraria from Astellas, BMS, MSD, Merck, Daichii-Sankyo, Servier and Roche. TQA has participated in consulting and/or advisory boards of GSK, MSD and Roche. CMC has participated in consulting and/or advisory boards for BeiGene, BMS, Astellas, Gilead, and MSD. Speaker honoraria from Astellas, BMS, MSD, and Roche. JFP received honoraria for speakers' bureau participation, and serving on advisory boards from Astellas, AstraZeneca, Bristol-Myers Squibb (BMS), Esteve, Merck Sharp & Dohme (MSD), Novartis, Nutricia, Pfizer, Rovi, Takeda, and Viatris and research grants from Astellas, AstraZeneca, BMS, and MSD. RHF Consultant or Advisory Role: Roche, Merck-Serono, Amgen, MSD, BMS, Lilly, Celgene, Sanofi-Aventis, Servier, Astra-Zeneca, Bayer, Astellas, Organon. Research Funding: Roche, Merck-Serono, Amgen, MSD, Lilly, Celgene, Sanofi-Aventis, Servier, Bayer. Speaking: Roche, Merck-Serono, Amgen, MSD, BMS, Lilly, Celgene, Sanofi-Aventis, Servier, Bayer. Grant support: Amgen, MSD, BMS. Ethics approval and consent to participate: Not applicable. Research involving human participants and/or animals and informed consent: Not applicable. Consent for publication: Not applicable.

Figures

Fig. 1
Fig. 1
Proposed algorithm for treatment of advanced GEA patients according to biomarker status. GEA patients are treated according to biomarkers evaluation, including MMR, HER2, CLDN18.2 and the score for PD-L1. Target therapies, including immunotherapy, are combined with chemotherapy according to the expression of the indicated biomarkers (adapted from 10.1016/j.esmogo.2024.100086)
Fig. 2
Fig. 2
Test algorithm for human epidermal growth factor receptor 2 (HER2) detection. HER2 expression is used to select patients that respond to target therapy. The modified Hoffman scoring system assesses HER2 membrane staining, intensity, and percentage of immunoreactive cells by immunohistochemistry. In equivocal cases (IHC 2 +), FISH/SISH/CISH is performed. IHC, immunohistochemistry; FISH, fluorescent in situ hybridization; SISH, silver in situ hybridization; CISH, chromogenic in situ hybridization, CEP17, Chromosome 17
See this image and copyright information in PMC

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