![]() Besides immunotherapy, also the total neoadjuvant treatment approach (TNT) in rectal cancer reached sufficient attention, changing our current standard of practice in 2021. During this meeting, evolving immunotherapy options were shown in the upper digestive tractus, already presented at ESMO 2020. The annual Gastrointestinal Cancers Symposium was held from 15 till 17 January 2021 in a virtual format. Survival rates were 51% and 39%, respectively, at 1 year, and 28% and 16%, respectively, at 2 years, reported Peter Enzinger, MD, Director of the Center for Esophageal and Gastric Cancer at Dana-Farber Cancer Institute.Authors: 1 Willem Lybaert MD, 2 Anne Demols MD PhD, 3 Isabel Dero MD, 4 Ivan Borbath MD PhD, 5 Joëlle Collignon MDġ Medical Oncology, AZ Nikolaas – AZ Lokeren – UZA, Sint-Niklaas – Lokeren – Antwerpen.Ģ Department of Gastro-enterology and GI oncology, Hôpital Erasme, Brussels.ģ Department of Gastro-enterology and GI oncology, AZ Monica, Antwerpen.Ĥ Department of Gastro-enterology/Hepatology and GI oncology, UCLouvain, Brussels.ĥ Medical Oncology, CHU-Sart-Tilman, Liège. In all patients, median overall survival was 12.4 months with pembrolizumab/chemotherapy vs 9.8 months with chemotherapy (HR = 0.73, P <. As in CheckMate 649, overall survival and progression-free survival were the dual primary endpoints. Patients were randomly assigned to receive pembrolizumab at 200 mg every 3 weeks for up to 35 cycles plus chemotherapy (fluorouracil plus cisplatin) for up to 6 cycles or chemotherapy alone. The phase III KEYNOTE-590 trial enrolled 749 patients, regardless of PD-L1 expression, with previously untreated advanced/unresectable or metastatic esophageal adenocarcinoma or esophageal squamous cell carcinoma or esophagogastric junction Siewert type 1 adenocarcinoma. Median progression-free survival was 7.7 and 6.1 months, respectively (HR = 0.68, P <. 0001) and for all randomly assigned patients (HR = 0.80, P =. The differences were also statistically significant for the PD-L1 CPS ≥ 1 population (HR = 0.77, P =. Median overall survival was 14.4 months with nivolumab/chemotherapy vs 11.1 months for chemotherapy in the PD-L1 CPS ≥ 5 population (hazard ratio = 0.71, P <. The dual primary endpoints were overall survival and progression-free survival in patients with a PD-L1 CPS ≥ 5. ![]() The chemotherapy regimen was either FOLFOX (fluorouracil, leucovorin, oxaliplatin) every 2 weeks or XELOX (capecitabine, oxaliplatin) every 3 weeks. Nivolumab plus ipilimumab (nivolumab/ipilimumab data will be presented at a later date).Nivolumab at 260 mg every 3 weeks or 240 mg every 2 weeks plus chemotherapy.Patients were randomly assigned to receive: The phase III trial included 1,581 patients with previously untreated HER2-negative advanced/unresectable or metastatic gastric cancer, gastroesophageal junction (GEJ) cancer, or esophageal adenocarcinoma, of whom 955 patients (60%) had a PD-L1 CPS ≥ 5. Nivolumab plus chemotherapy represents a potential standard first-line treatment.” “The study achieved statistical significance for both primary endpoints and all formally tested secondary endpoints. “Nivolumab is the first PD-1 inhibitor to demonstrate superior overall survival and progression-free survival in combination with chemotherapy vs chemotherapy alone in previously untreated patients with advanced gastric cancer, gastroesophageal junction cancer, or esophageal adenocarcinoma,” he said.
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