Immunotherapy brings real hope in advanced esophageal cancer. A disease that no current chemotherapy can stabilize.
Patients with advanced cancer of the esophagus or gastroesophageal junction generally have a poor prognosis and current recommendations do not offer specific treatment for this.
Anti-PD1 immunotherapy would represent a new opportunity for these patients according to a placebo-controlled study which was published in The Lancet.
Patients with treatment failure
A group of researchers evaluated the efficacy and safety of an immunotherapy, nivolumab, an anti-PD-1 monoclonal antibody in patients with advanced cancer of the esophagus or gastroesophageal junction by failure of at least 2 chemotherapies.
To do this, patients with this type of cancer and intolerant to standard treatment or to other therapeutic antibodies acting on the regulation of T lymphocytes were recruited. They were drawn into 2 groups: the first group received 3 mg / kg of nivolumab and the 2e group received intravenous placebo every 2 weeks.
Study treatment was continued until disease progression, according to the investigator, or the appearance of toxicities requiring permanent discontinuation.
Nivolumab sparks hope
Neither the patients nor the researchers knew the treatment they were receiving. The primary endpoint was overall survival in the intention-to-treat population. Safety was analyzed in all patients who received at least one dose of study treatment.
The doubling of overall survival in the nivolumab monotherapy group (26.2 months versus 10.6 months in the placebo group) demonstrates that nivolumab, or another PD1 / PDL1 inhibitor, could be a new treatment option in patients with patients with advanced cancer of the esophagus or gastroesophageal junction. The tolerance observed in this population of patients is consistent with what was observed in the other nivolumab studies on other cancers, with no new toxicity compared to what is known.
This study enabled the initiation of further studies with nivolumab in cancer of the esophagus or gastroesophageal junction in various combinations of chemotherapy and in earlier stages of cancer.
.