Digestive system cancers represent a group of malignancies with high global incidence and a particularly heavy disease burden in China. Among these, gastric cancer, colorectal cancer, and biliary tract cancer represent critical human epidermal growth factor receptor 2 (HER2)-positive subtypes that require focused clinical attention. Antibody–drug conjugates (ADCs), which utilize HER2-targeted monoclonal antibodies to deliver cytotoxic agents directly to tumor cells, have revolutionized precision therapy in HER2-positive cancers, marking a significant milestone in oncologic treatment. Currently, trastuzumab deruxtecan and disitamab vedotin have been approved for the treatment of advanced gastric cancer. This expert consensus emphasizes the safety management of HER2 ADCs in digestive system cancers, considering the unique anatomical complexity and the vulnerability of the mucosal barrier in this system. It underscores the essential role of multidisciplinary team collaboration in standardizing the management of adverse events and offers evidence-based recommendations to guide clinical practice across primary and secondary care settings. Furthermore, it underscores the value of a “physician-led, patient-engaged” model in patient education. The safety management experience accumulated in this context also offers important insights for the clinical application of ADCs targeting other oncogenic pathways.

Robot surgery is an important trend in contemporary colorectal cancer surgical treatment. The Robotic Surgery Group, Colorectal Cancer Committee of Chinese Medical Doctor Association organized experts in relevant fields across the country to update and revise the application standards of robotic colorectal cancer surgery based on the Expert consensus on robotic surgery for colorectal cancer (2015 edition) and the revised version in 2020, in accordance with the development of robotic surgery concepts, technologies, and equipment in recent years, in order to promote the application and promotion of robotic surgery.