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In a study reported in The Lancet Oncology, Pilonis et al found that nonendoscopic cell collection device (marked as the Cytosponge)–detected atypia and p53 overexpression could be used in combination with clinical risk factors to triage patients with Barrett’s esophagus for endoscopic...
In an Asian phase II/III trial (ATTRACTION-4) reported in The Lancet Oncology, Yoon-Koo Kang, MD, and colleagues found that the addition of nivolumab to oxaliplatin-based chemotherapy improved progression-free survival—but not overall survival—as first-line treatment of HER2-negative, unresectable, ...
Two recent studies correct a long-standing misconception about the origins of Barrett’s esophagus and, in doing so, may point to new avenues of treatment or prevention to lower the risk of esophageal cancer. The first study, published by Singh et al in the journal Gastroenterology, demonstrated...
In an analysis reported in the Journal of Clinical Oncology, Zhao et al found that the addition of an immune checkpoint inhibitor to chemotherapy in trials of first-line treatment of advanced gastric or esophageal adenocarcinoma was not associated with benefit in low PD-L1–expressing subgroups not...
In a study reported in the Journal of Clinical Oncology, Adenis et al found that health-related quality of life was maintained with both pembrolizumab and chemotherapy in the pivotal phase III KEYNOTE-181 trial, which included patients with advanced esophageal cancer who had received previous...
Over the past month, the U.S. Food and Drug Administration (FDA) issued several regulatory decisions for novel treatments for patients with cancer. Priority Review for Relatlimab and Nivolumab Fixed-Dose Combination in Unresectable or Metastatic Melanoma The FDA accepted for Priority Review the...
There is no doubt that subsets of patients with esophageal and gastric cancers benefit from immune checkpoint inhibitor therapy. The complexity lies in identifying the appropriate histology, tumor location, expression of programmed cell death receptors and ligands, mechanism of checkpoint...
As reported in The Lancet by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and...
In the primary analysis of the phase II DESTINY-Gastric02 trial, fam-trastuzumab deruxtecan-nxki (T-DXd) produced clinically meaningful and durable responses in Western patients with advanced HER2-positive gastric or gastroesophageal junction cancers whose disease had progressed after a...
Patients who had advanced gastroesophageal cancer but were considered unsuitable for full-dose chemotherapy because of their advanced age and/or frailty “had an improved patient experience with no significant detriment in cancer control” when treated with reduced-intensity chemotherapy in the phase ...
On May 5, 2021, pembrolizumab was granted accelerated approval for use in combination with trastuzumab and fluoropyrimidine- and platinum-containing chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic HER2-positive gastric or gastroesophageal...
As reported in The Lancet by Sun et al, the phase III KEYNOTE-590 trial showed that the addition of first-line pembrolizumab to chemotherapy resulted in improved overall and progression-free survival in patients with advanced esophageal and Siewert type 1 gastroesophageal junction (GEJ) cancers....
The RATIONALE 302 trial1 was discussed by Kei Muro, MD, PhD, of Aichi Cancer Center Hospital in Nagoya, Japan, who found the results promising. However, Dr. Muro questioned the role of PD-1/L1 inhibitors as second-line therapy for advanced esophageal squamous cell carcinoma. RATIONALE 302 is the...
In the phase III RATIONALE 302 trial, the novel anti–PD-1 antibody tislelizumab, being developed in China, improved overall survival vs chemotherapy as second-line therapy for esophageal squamous cell carcinoma, according to Jaffer Ajani, MD, of The University of Houston MD Anderson Cancer Center,...
In a Chinese phase III trial reported in JAMA Oncology, Ji et al found that concurrent chemoradiation with S-1 was associated with improved overall survival and acceptable toxicity vs radiotherapy alone in older patients with esophageal cancer. As stated by the investigators, “Most older patients ...
In the Chinese phase III RESOLVE trial reported in The Lancet Oncology, Zhang et al found that perioperative S-1/oxaliplatin was superior to—and adjuvant S-1/oxaliplatin was noninferior to—adjuvant capecitabine/oxaliplatin in terms of disease-free survival in patients undergoing D2 gastrectomy for...
On March 22, 2021, pembrolizumab was approved for use in combination with platinum- and fluoropyrimidine-based chemotherapy for patients with metastatic or locally advanced esophageal or gastroesophageal junction (tumors with epicenter 1 to 5 cm above the gastroesophageal junction) carcinoma who...
In a retrospective analysis reported by researchers from the International Esodata Study Group (IESG) in JAMA Surgery, D’Journo et al developed a model for predicting risk of 90-day mortality following esophagectomy for patients with esophageal or gastroesophageal junction cancer. As stated by the...
In a Dutch phase III trial (ARTDECO) reported in the Journal of Clinical Oncology, Hulshof et al found that increasing the dose of radiation therapy in a definitive chemoradiation regimen did not improve local progression-free survival in patients with inoperable, locally advanced esophageal...
As reported in The Lancet by Yelena Y. Janjigian, MD, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and progression-free survival among patients with advanced HER2-negative gastric, gastroesophageal ...
As reported in the Journal of Clinical Oncology by Karyn A. Goodman, MD, and colleagues, mature results of the phase II CALGB 80803/Alliance trial indicated that treatment guided by early positron-emission tomography (PET) assessment of response to induction neoadjuvant chemotherapy improved...
The CheckMate 577 trial—reported in The New England Journal of Medicine by Kelly et al1 and reviewed in this issue of The ASCO Post—is the first global randomized controlled trial for patients with resectable esophageal cancer that showed a significant disease-free survival benefit for adjuvant...
As reported in The New England Journal of Medicine by Ronan J. Kelly, MB BCh, MBA, of The Charles A. -Sammons Cancer Center at Baylor University Medical Center, and colleagues, an interim analysis of the phase III CheckMate 577 trial has shown a significant improvement in disease-free survival...
The first results from the phase III CheckMate 648 study represent significant progress in the treatment of patients with advanced esophageal squamous cell carcinoma. The trial evaluated first-line treatment with nivolumab plus chemotherapy or nivolumab plus ipilimumab in patients with advanced...
Ian Chau, MD, of Royal Marsden NHS Foundation Trust, discusses first results of the CheckMate 648 study, which showed that nivolumab plus chemotherapy and nivolumab plus ipilimumab both demonstrated superior overall survival vs chemotherapy alone in patients with advanced esophageal squamous cell carcinoma. These regimens may represent potential new first-line treatment options (Abstract 4001).
In the phase III GO2 trial reported in JAMA Oncology, Hall et al found that reduced-intensity oxaliplatin/capecitabine was associated with improved patient experience, reduced toxicity, and noninferior progression-free survival compared with higher-intensity treatment among older and frail patients ...
On May 20, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) for patients with completely resected esophageal or gastroesophageal junction cancer with residual pathologic disease who have received neoadjuvant chemoradiotherapy. CheckMate 577 Efficacy was evaluated in CheckMate ...
On April 16, 2021, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) in combination with fluoropyrimidine- and platinum-containing chemotherapy for advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma. CheckMate 649 The...
On May 5, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) in combination with trastuzumab plus fluoropyrimidine- and platinum-containing chemotherapy for the first-line treatment of patients with locally advanced unresectable or metastatic...
As reported in the Journal of Clinical Oncology by Eyck et al, 10-year follow-up of the Dutch CROSS trial has shown a continued overall survival benefit with neoadjuvant chemoradiotherapy plus surgery vs surgery alone in patients with locally advanced resectable esophageal or gastroesophageal...
More news has emerged from this week’s meeting of the U.S. Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC). The group voted 8 to 0 in favor of continuing the accelerated approval for pembrolizumab in sorafenib-pretreated patients with hepatocellular carcinoma; 6 to 2...
The U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to bemarituzumab as first-line treatment for patients with fibroblast growth factor receptor 2b (FGFR2b)-overexpressing and HER2-negative metastatic and locally advanced gastric and gastroesophageal adenocarcinoma...
Today, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) in combination with fluoropyrimidine- and platinum-containing chemotherapy for advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma. CheckMate 649 The efficacy of the...
As reported in The New England Journal of Medicine by Ronan J. Kelly, MBBCh, MBA, and colleagues, an interim analysis of the phase III CheckMate 577 trial has shown a significant improvement in disease-free survival with adjuvant nivolumab vs placebo in patients with resected esophageal or...
In an analysis reported in JAMA Oncology, Joseph Chao, MD, and colleagues found improved outcomes with pembrolizumab treatment in patients with microsatellite instability–high (MSI-H) advanced gastric or gastroesophageal junction cancer, irrespective of line of treatment. The findings suggest that...
A combination of esophageal brushing and extensive genetic sequencing of the sample collected may detect chromosome alterations in people with Barrett’s esophagus, identifying patients at risk for progressing to esophageal cancer. These findings were published by Douville et al in ...
Crystal S. Denlinger, MD, of Fox Chase Cancer Center, and Mary F. Mulcahy, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discuss biomarkers for determining treatment; immune checkpoint inhibitors; when to employ such treatments as platinum/fluoropyrimidine and fam-trastuzumab deruxtecan-nxki; and other second- or later-line therapies such as paclitaxel, ramucirumab, irinotecan-based regimens, and trifluridine/tipiracil.
In an early analysis from a Chinese phase III trial reported in JAMA Surgery, Wang et al found similar safety and improved histopathologic outcome among patients undergoing minimally invasive esophagectomy for locally advanced esophageal squamous cell carcinoma following neoadjuvant...
Adjuvant nivolumab is the first therapy to provide a statistically significant and clinically meaningful improvement in disease-free survival in patients with resected esophageal and gastroesophageal junction cancer, according to research presented by Guillaume Piessen, MD, PhD, and colleagues at...
The FIGHT study’s invited discussant, Rutika Mehta, MD, MPH, a gastrointestinal oncologist at Moffitt Cancer Center, Tampa, Florida, noted the emergence of new biomarkers and their targeted agents in HER2-negative gastric or gastroesophageal junction cancer. Two important ones are FGFR2b—now...
Gastric cancer appears to have a new druggable target: fibroblast growth factor receptor 2b (FGFR2b). Targeting FGFR2b with bemarituzumab plus chemotherapy led to clinically meaningful and statistically significant improvements in progression-free survival, overall survival, and response rate in...
On March 22, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) in combination with platinum and fluoropyrimidine-based chemotherapy for patients with metastatic or locally advanced esophageal or gastroesophageal junction (tumors with epicenter 1–5 cm above the...
In long-term follow-up of the French phase III MIRO trial reported in JAMA Surgery, Nuytens et al found no significant difference in 5-year overall or disease-free survival with hybrid minimally invasive esophagectomy vs open esophagectomy in patients with esophageal cancer. In the multicenter...
An analysis of 58 peripheral blood specimens from patients with rectal and esophageal cancers demonstrated that circulating hybrid cells may be a novel, noninvasive biomarker with potential for monitoring treatment response and disease progression to help guide decisions for further therapy,...
As reported in the Journal of Clinical Oncology by Manish A. Shah, MD, and colleagues, the phase III GAMMA-1 trial showed no improvement in overall survival with the addition of andecaliximab to modified oxaliplatin, leucovorin, and fluorouracil (mFOLFOX6) in the first-line treatment of...
The U.S. Food and Drug Administration (FDA) recently granted Priority Review to nivolumab as either adjuvant or first-line therapy in several types of gastric cancers, as well as to a novel PD-1 inhibitor for locally advanced or metastatic squamous cell carcinoma of the anal canal. The FDA also...
In a Chinese single-institution phase III trial reported in the Journal of Clinical Oncology, Lu et al found that early interdisciplinary supportive care with a focus on nutrition and psychological status was associated with improved overall survival vs standard care in previously untreated...
In a new study published by Kawasaki et al in the journal Cancer, researchers reported that certain oral pathogens are more prevalent in patients with esophageal cancer, and pointed out this information may be used as a novel diagnostic tool. The oral cavity is a rich source of microbial diversity, ...
Dostarlimab, a monoclonal antibody targeting PD-1, showed strong and durable antitumor activity in patients with mismatch repair–deficient (dMMR) gastrointestinal tumors in the phase I GARNET study, reported Thierry André, MD, of Sorbonne Université and Hôpital Saint Antoine, Paris, and colleagues...
Gastric cancer has a new target: fibroblast growth factor receptor 2b (FGFR2b). Targeting FGFR2b with bemarituzumab plus chemotherapy led to clinically meaningful and statistically significant improvements in progression-free survival, overall survival, and response rates in the randomized phase II ...