![]() The OS- and PFS-benefit observed in the adenocarcinoma subgroup was consistent with the benefit observed in the overall patient population.Ĭommenting on the findings, Al-Batran said: “I expect that KEYNOTE-590 will change practice for patients with metastatic squamous cell carcinoma or adenocarcinoma of the oesophagus who have PD-L1 CPS >10 tumours, for whom pembrolizumab added to chemotherapy will become the standard of care in the first-line.”Īl-Batran concluded: “The results of these trials offer oncologists new treatment options. The results in the subgroup of patients with adenocarcinoma were an experimental analysis, but in the adenocarcinoma subgroup, median overall survival (OS) was 11.6 months and 9.9 months (hazard ratio =0.74), and median progression-free survival (PFS) was 6.3 months and 5.7 months (HR=0.63) in the Pembro+Chemo and Chemo group, respectively. ![]() Most oesophageal cancer patients in the trial had squamous cell carcinoma (73%) and those with adenocarcinoma were a small subgroup. Progression-free survival was also improved. The open question is the effect in patients who have a PD-L1 CPS 10 tumours, all squamous cell carcinomas, all patients with CPS >10, and the study population as a whole. Based on this trial, for patients with HER2-negative gastric adenocarcinoma, oesophageal adenocarcinoma, or gastro-oesophageal junctional adenocarcinoma with PD-L1 CPS >5 tumours, the addition of nivolumab to chemotherapy will become the standard of care for first-line treatment. MSI-High) are planned to better characterise the efficacy benefit in patients across all CPS cutoffs.Ĭommenting on the new data, Prof Salah-Eddin Al-Batran, Director, Institute of Clinical Cancer Research and Director of GI Oncology, Krankenhaus Nordwest-University Cancer Centre, Frankfurt, Germany, ESMO 2020 upper GI track chair, said: “The results are clinically very relevant. Improvements were also observed in patients with PD-L1 CPS >1 tumours and in the overall patient population.Īdditional analysis of subgroups and biomarkers (e.g. The results show that nivolumab and chemotherapy improved overall survival and progression-free survival in patients with PD-L1 combined positive score (CPS) >5 tumours. The CheckMate 649 trial (1) evaluated nivolumab plus chemotherapy versus chemotherapy alone as first-line treatment in patients with non-HER-2-positive advanced gastric cancer, gastro-oesophageal junction cancer, or oesophageal cancer – all with adenocarcinoma histology. ![]() Three studies provide evidence, based on different patient populations and different immune checkpoint inhibitors used as first-line therapy. Immune therapy would be a big change in treatment, since immune checkpoint inhibitors are not yet approved for early therapy in Western countries. LUGANO, Switzerland - New data presented at ESMO 2020 have shown that immunotherapy is beneficial for patients with gastric and oesophageal cancers who currently have poor survival.
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