One year after the virtual ASCO GI 2021 meeting, this year’s conference was organised in San Francisco from 20 till 22 January 2022, as a hybrid event in the background of a rising Omicron gulf in Europe and the United States. It was an excellent meeting with the use of immune checkpoint inhibitors in oesophageal and gastric cancer brought in a more critical perspective. Immunotherapy is also pushing forward in the first-line treatment of biliary tract cancer, and combination immunotherapy in the first phase 3 first-line study in hepatocellular carcinoma. Immunotherapy as a neoadjuvant approach in MSI-high local gastric/GEJ tumours and locally advanced rectal cancer seems to start up as a possible new paradigm in the near future. A lot of running studies are looking for the exact place of circulating tumour DNA as a tool in the management of colorectal cancer. Trastuzumab-deruxtecan is flying over from breast cancer in the field of digestive oncology as a very active new kid on the block. In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.

(BELG J MED ONCOL 2022;16(3):142–53)