Dr. Zalupski on Implications of the KEYNOTE-061 Trial in Gastric Cancer

Mark M. Zalupski, MD, professor of medicine at the University of Michigan School of Medicine, discusses the clinical implications of the phase III KEYNOTE-061 trial in gastric cancer.

The purpose of the trial was to demonstrate the value of PD-1 antibody therapy with pembrolizumab (Keytruda) in patients with metastatic gastric cancer, says Zalupski. However, the study did not demonstrate that immunotherapy was more efficacious than chemotherapy in the second-line setting. This was especially true for unselected patients and for patients who were PD-L1—positive on staining. However, a small fraction of patients did appear to have some benefit from PD-1 antibody therapy, he adds.

For patients who have high combined positive score or microsatellite instability—high tumors, anti–PD-1 therapy may be useful. Additional research into combining immunotherapy with chemotherapy in the second-line setting may also prove beneficial, although ongoing trials will have to further define its use and value, concludes Zalupski.