{"entity":{"id":"paper-matterhorn-nejm-2025","kind":"paper","name":"MATTERHORN: perioperative durvalumab with FLOT chemotherapy for resectable gastric and gastro-oesophageal junction cancer","aka":[],"tldr":"Adding durvalumab to perioperative FLOT chemotherapy for operable stomach cancer reduced recurrences and doubled the rate of complete pathological response, the first immunotherapy to improve outcomes in curable gastric cancer.","summary":"Phase 3 placebo-controlled trial of 948 patients with resectable stage II to IVA gastric or gastro-oesophageal junction adenocarcinoma randomised to perioperative FLOT with durvalumab or placebo, followed by durvalumab or placebo maintenance.\n\nEvent-free survival at 24 months was 67.4 versus 58.5 percent (hazard ratio 0.71), pathological complete response 19 versus 7 percent, and an interim overall survival analysis favoured durvalumab; surgery rates and toxicity were similar between arms.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2025","url":"https://doi.org/10.1056/NEJMoa2503701"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/40454643/"}],"tags":[],"related":[],"cancers":["gastric-pdl1-high"],"sections":[],"technologies":[],"targets":[],"drugs":["durvalumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["matterhorn"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2025,"doi":"10.1056/NEJMoa2503701","pmid":"40454643","authors":"Janjigian YY, Al-Batran SE, Wainberg ZA, et al.","paperType":"rct","findings":["24-month event-free survival 67.4 percent vs 58.5 percent; hazard ratio 0.71.","Pathological complete response 19 percent vs 7 percent."],"whatItMeans":"Perioperative durvalumab with FLOT is a new standard for resectable gastric and junctional adenocarcinoma irrespective of PD-L1 expression.","caveats":["Overall survival analysis interim.","Applicability to Asian populations receiving adjuvant-only chemotherapy is uncertain."],"changedPractice":true,"participants":948},"route":"/key-papers/paper-matterhorn-nejm-2025/","neighbours":{"cancer":[{"id":"gastric-pdl1-high","kind":"cancer","name":"PD-L1-high gastric cancer","route":"/cancers/gastric-pdl1-high/"}],"drug":[{"id":"durvalumab","kind":"drug","name":"Durvalumab","route":"/drugs/durvalumab/"}],"trial":[{"id":"matterhorn","kind":"trial","name":"MATTERHORN","route":"/trials/matterhorn/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}