For advanced or metastatic cancer of the stomach and esophagus comes European approval for the combination of immunotherapy and chemotherapy as the first line of treatment. The green light from the European Commission is based on the results of the CheckMate -649 clinical study: the combination of nivolumab and chemotherapy has in fact been shown to extend both overall survival and progression-free survival compared to chemotherapy alone.
ESMO 2020
Gastric and esophageal cancer, immunotherapy increases survival even in less common forms
Gastric and esophageal tumors
Stomach (or gastric) cancer is the fifth most common malignancy and the fourth leading cause of cancer death worldwide. This name actually encompasses numerous cancers, including those that form in the gastroesophageal junction, the area of the digestive tract that connects the esophagus and stomach. Cancer of the gastroesophageal junction has a lower prevalence than gastric cancer, but is continuously increasing. Cancer of the esophagus follows that of the stomach in the rankings of incidence and mortality: it is the seventh most common and the sixth cause of cancer death worldwide. The two most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma, which account for approximately 85% and 15% of all esophageal cancers, respectively, although esophageal cancer histology may vary by region, with the highest adenocarcinoma rate in North America (65%) and Europe (~ 40%).
Tumors, with combinations of immuno-oncology the response increases by 60%
by IRMA D’ARIA
The new treatment
The new therapeutic regimen has been approved for adult patients with adenocarcinoma of the stomach, gastroesophageal junction (GEJ) or esophagus (EAC), HER2 negative, advanced or metastatic, and who express the PD-L1 protein, a marker used for identify tumors that have a greater chance of responding to immunotherapy. “The approval is a major milestone for many patients with adenocarcinoma of the stomach, gastroesophageal junction and esophagus, who will now have a new treatment option available that has demonstrated greater overall survival than the traditional standard of care,” commented Ian M. Waxman, MD, development lead, gastrointestinal cancers of Bristol Myers Squibb, the pharmaceutical company that makes nivolumab. “After the limited progress of the past decade in HER2 negative gastric cancers, we are particularly pleased to contribute to the advancement in this field with the introduction of the nivolumab-based combination for patients in the European Union.”