Results from studies in upper gastrointestinal cancer presented at the 2018 American Society of Clinical Oncology (ASCO) meeting are promising. Prophylactic treatment of Barrett’s esophagus with high proton pump inhibitor therapy plus aspirin showed positive results on death, esophageal adenocarcinoma and dysplasia. Current studies on the treatment of gastric cancer included the following: S‑1 plus docetaxel as postoperative adjuvant chemotherapy in Asian patients, triplet therapy (cisplatin, S1, and docetaxel) in Asian patients, paclitaxel vs. pembrolizumab, and a biomarker study for trastuzumab continuation. Advances in the treatment of pancreatic cancer are likely to be practice changing: combined chemotherapy mFOLFIRINOX clearly improved disease-free survival in patients with resected pancreatic ductal adenocarcinomas. In the palliative setting, the introduction of FOLFIRINOX and gemcitabine/nab-paclitaxel may allow treatment with lower toxicity and allow broader patient selection. In the treatment of cholagiocellular cancer, gemcitabine plus S‑1 was non-inferior to gemcitabine plus cisplatin. Preliminary data in the treatment of neoendocrine tumors with temozolomide plus capecitabine are promising. Finally, the second-line treatment of hepatocellular carcinoma with ramucirumab showed a significant survival benefit.