Five liver societies issue joint definition of acute-on-chronic liver failure; claudin 18.2 ADC doubles survival in gastroesophageal cancer

• Guidelines Oct 30, 2026
  Five liver societies publish joint definition and three-grade system for acute-on-chronic liver failure
  The American Association for the Study of Liver Diseases (AASLD) and the European, Asian Pacific, Latin American and African liver societies published an 81-statement consensus on acute-on-chronic liver failure (ACLF) on Oct. 30. It applies to advanced chronic liver disease and requires bilirubin of 5 mg/dL or more and an international normalized ratio of 1.5 or more, plus at least one extrahepatic organ dysfunction or failure. Grade 1 adds one extrahepatic organ dysfunction, grade 2 one extrahepatic organ failure and grade 3 two or more organ failures, according to HCPLive. It recommends against corticosteroids in grade 3.
  Sources: Hepatology, AASLD, HCPLive
• Research Oct 25, 2026
  Sonesitatug vedotin doubles median survival to 10.0 months in later-line claudin 18.2-positive gastroesophageal cancer
  In the phase 3 CLARITY-Gastric01 trial, 594 patients with previously treated claudin 18.2-positive (at least 25% membranous staining) advanced gastroesophageal carcinoma were randomly assigned, including 267 to sonesitatug vedotin 2.2 mg/kg every 3 weeks and 265 to investigator's choice. In the third-line or later population, median overall survival, a dual primary end point, was 10.0 versus 5.0 months (hazard ratio 0.47, 95% CI 0.36 to 0.62). The other primary end point, progression-free survival, was 4.2 versus 3.8 months and was not statistically significant (P = .053). The data were presented Oct. 25 at the European Society for Medical Oncology Congress.
  Sources: AstraZeneca, Targeted Oncology
• Research Oct 25, 2026
  Ivonescimab plus chemotherapy improves overall survival to 14.9 months in first-line biliary tract cancer, Summit says
  In the phase 3 HARMONi-GI1 trial of 682 patients in China with previously untreated advanced biliary tract cancer, ivonescimab plus gemcitabine and cisplatin improved median overall survival, the primary end point, to 14.9 months from 12.1 months with durvalumab plus the same chemotherapy at an interim analysis (hazard ratio 0.75, 95% CI 0.61 to 0.92), according to Summit Therapeutics. Median progression-free survival was 8.4 versus 5.8 months. Ivonescimab is not approved in the U.S., and the Akeso-sponsored trial was presented at the European Society for Medical Oncology Congress.
  Sources: Summit Therapeutics, Targeted Oncology

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