Ilson Delves Into the Development of Checkpoint Inhibition in Gastric/GEJ Cancers

Welcome to OncLive On Air^®! I’m your host today, Jessica Hergert.

OncLive On Air^® is a podcast from OncLive^®, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive^® covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

In today’s episode, sponsored by Eli Lilly, we had the pleasure of speaking with David H. Ilson, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, to discuss current approaches to the treatment of patients with advanced or metastatic gastric cancer, gastroesophageal junction (GEJ) cancer, and esophageal adenocarcinoma following the approvals of 2 chemoimmunotherapy combinations in the frontline setting.

On May 5, 2021, the FDA approved pembrolizumab (Keytruda) plus trastuzumab (Herceptin), fluoropyrimidine- and platinum-containing chemotherapy for the frontline treatment of patients with locally advanced unresectable or metastatic HER2 positive gastric or GEJ adenocarcinoma. The regulatory decision was based on findings from a prespecified interim analysis of the first 264 patients enrolled to the KEYNOTE-811 trial (NCT03615326), which showed that the chemoimmunotherapy combination elicited an overall response rate (ORR) of 74% (95% CI, 66%-82%) vs 52% (95% CI, 43%-61%) with placebo (one-sided P <.0001).

Shortly thereafter, on April 16, 2021, the FDA approved nivolumab (Opdivo) plus select types of chemotherapy for the frontline treatment of patients with advanced or metastatic gastric cancer, GEJ cancer, and esophageal adenocarcinoma.

Data from the phase 3 CheckMate-649 trial (NCT02872116) showed that nivolumab plus leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) or capecitabine and oxaliplatin resulted in a significant improvement in survival in treatment-naïve patients who had PD-L1–positive advanced gastric cancer, GEJ cancer, and esophageal adenocarcinoma vs chemotherapy alone.

In our exclusive interview, Ilson discussed treatment sequencing for patients with gastric/GEJ cancer, the integration of immunotherapy into the frontline setting, and key ongoing studies in the field.

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