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Impact on the Sustainable Development Goals (SDGs)

Analysis of institutional authors

Guardeño, RAuthorBuges, CAuthor

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January 15, 2026
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A Phase II Study of Perioperative Avelumab plus Chemotherapy for Patients with Resectable Gastric Cancer or Gastroesophageal Junction Cancer - The MONEO Study

Publicated to: CLINICAL CANCER RESEARCH. 31 (14): 2890-2898 - 2025-07-15 31(14), DOI: 10.1158/1078-0432.CCR-25-0369

Authors:

Alsina, M; Villacampa, G; de Andrea, C; Vivancos, A; Ponz-Sarvise, M; Arrazubi, V; Jimenez-Fonseca, P; Diez, M; Sanz-Garcia, E; Martínez, E; Guardeño, R; Calvo, M; Bugés, C; Longo, F; Navarro, V; García-Galea, E; Gros, A; Ochoa, MC; Lopez-Janeiro, A; Sanchez-Gregorio, S; Herrero, C; Labiano, I; Vila-Casadesús, M; López, D; Alexandru, R; Muñoz, S; Tabernero, J; Melero, I
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Affiliations

Canc Ctr Clin Univ Navarra CCUN, CIMA IdiSNA Univ Navarra, Program Solid Tumors - Author
CiMA - Author
Ctr Appl Med Res CIMA, Program Immunol & Immunotherapy - Author
Hosp Germans Trias i Pujol, Inst Catala Oncol ICO, Med Oncol Dept - Author
Hosp Josep Trueta, Inst Catala Oncol, Med Oncol Dept - Author
Hosp Univ Cent Asturias, Med Oncol Dept, ISPA - Author
Hosp Univ Marques de Valdecilla, Med Oncol Dept, Inst Invest IDIVAL - Author
Hosp Univ Navarra, Med Oncol Dept - Author
Inst Catala Oncol IDIBELL, Med Oncol Dept - Author
Navarrabiomed IdiSNA, Translat Med Oncol Unit - Author
Univ Alcala, Hosp Univ Ramon y Cajal, Med Oncol Dept, IRICYS,CIBERONC - Author
Univ Hlth Network, Princess Margaret Canc Ctr, Toronto - Author
Univ Navarra, Clin Univ Navarra, Ctr Invest Biomed Red Canc - Author
Univ Navarra, Clin Univ Navarra, Ctr Invest Biomed Red Canc CIBERONC - Author
Univ Oxford, Nuffield Dept Med - Author
Vall dHebron Barcelona Hosp Campus - Author
Vall dHebron Inst Oncol VHIO - Author
Vall dHebron Inst Oncol VHIO, Canc Genom - Author
Vall dHebron Inst Oncol VHIO, Stat Unit - Author
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Abstract

Purpose: Immune checkpoint inhibitors combined with chemotherapy have provided successful results in patients with gastric and gastroesophageal junction (G/GEJ) cancers in the metastatic setting. Similar strategies have been explored in earlier stages. In this study, we present the final results of the phase II MONEO trial, which evaluated the addition of avelumab to neoadjuvant chemotherapy.Patients and Methods: Patients with untreated, resectable G/GEJ adenocarcinoma received neoadjuvant treatment with four cycles of avelumab plus the FLOT4 regimen, followed by surgery. Upon postoperative recovery, patients underwent four additional adjuvant cycles of the same combination, followed by avelumab monotherapy for up to 1 year. The primary endpoint was pathologic complete response rate. Sequential flow cytometry and cytokine determination were performed in peripheral blood, along with multiplex tissue immunofluorescence and RNA sequencing in tumor specimens.Results: Forty patients were enrolled, achieving a pathologic complete response rate of 21.1% (95% confidence interval, 10.0-37.0). The major pathologic response rate was 28.9%, more pronounced in patients with tumors expressing PD-L1 before treatment as measured by the combined positive score (cutoff, 10; 33.3% vs. 21.1%). The results propose several potential biomarkers considering tumor immune infiltrate, circulating immune cells, and cytokines. Eighty percent of patients experienced treatment-related grade >= 3 adverse events.Conclusions: The combination of avelumab plus the FLOT4 regimen showed relatively modest efficacy in resectable G/GEJ adenocarcinoma. Better results were observed in PD-L1 combined positive score >= 10% tumors. Exploratory biomarker analyses provide insights that may help to identify candidates most likely to benefit from chemoimmunotherapy as a neoadjuvant treatment.
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Keywords

AdenocarcinomaAdultAgedAntibodies, monoclonal, humanizedAntineoplastic agentAntineoplastic combined chemotherapy protocolsArticleAvelumabCancer patientCancer stagingCancer surgeryCancer survivalClinical articleClinical trialComputer assisted tomographyControlled studyCxcl1 chemokineDiarrheaDocetaxelDrug effectDrug therapyEsophagealEsophageal neoplasmsEsophagogastric junctionEsophagus cancerEsophagus tumorFatigueFemaleFluorouracilFolinic acidFollow upGastroesophageal junctionGastroesophageal junction cancerGood health and well-beingHumanHumansImmunocompetent cellMaleMiddle agedMonoclonal antibodyMulticenterMulticenter studyMultiple cycle treatmentNausea and vomitingNeoadjuvant chemotherapyNeoadjuvant therapyNeutropeniaNivolumabOpen-labelOverall survivalOxaliplatinPathologyPhase 2 clinical trialProceduresProgression free survivalStomach cancerStomach neoplasmsStomach tumorSurgeryTreatment outcomeTreatment responseTumor volume

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal CLINICAL CANCER RESEARCH due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2025, it was in position 29/328, thus managing to position itself as a Q1 (Primer Cuartil), in the category Oncology. Notably, the journal is positioned above the 90th percentile.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-02:

  • WoS: 4
  • Scopus: 4
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 15.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 8 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 1.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Continuing with the social impact of the work, it is important to emphasize that, due to its content, it can be assigned to the area of interest of ODS 3 - Good Health and Well-Being, with a probability of 84% according to the mBERT algorithm developed by Aurora University.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Canada; United Kingdom.

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