Dr. Davis on Caveats of the KEYNOTE-062 Trial Findings in Gastric/GEJ Cancer

S. Lindsey Davis, MD
Published: Monday, Jun 24, 2019



S. Lindsey Davis, MD, an assistant professor of medicine and gastrointestinal medical oncologist at the University of Colorado Cancer Center, discusses caveats of the phase III KEYNOTE-062 trial findings in gastric and gastroesophageal junction (GEJ) cancer.

Immunotherapy has garnered a lot of excitement in gastric and GEJ cancer, following the incorporation of several FDA-approved agents in the third-line setting for patients with PD-L1–positive disease. However, there have been some setbacks, explains Davis.

For example, data from the KEYNOTE-062 trial were negative. The addition of frontline pembrolizumab (Keytruda) to standard cisplatin and either 5-fluorouracil or capecitabine did not show a significant benefit in overall survival, progression-free survival, or response rate in patients with advanced gastric/GEJ cancer versus chemotherapy alone. However, there are several ongoing studies exploring immunotherapy in various lines of therapy.

Notably, investigators observed some benefit in patients who had a PD-L1 (combined positive score [CPS]) of ≥1; these patients experienced a better response with the addition of pembrolizumab to standard chemotherapy. Moreover, a subsequent analysis showed that patients with even higher scores—a CPS of 10—seemed to have even better outcomes with that type of therapy, concludes Davis.
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S. Lindsey Davis, MD, an assistant professor of medicine and gastrointestinal medical oncologist at the University of Colorado Cancer Center, discusses caveats of the phase III KEYNOTE-062 trial findings in gastric and gastroesophageal junction (GEJ) cancer.

Immunotherapy has garnered a lot of excitement in gastric and GEJ cancer, following the incorporation of several FDA-approved agents in the third-line setting for patients with PD-L1–positive disease. However, there have been some setbacks, explains Davis.

For example, data from the KEYNOTE-062 trial were negative. The addition of frontline pembrolizumab (Keytruda) to standard cisplatin and either 5-fluorouracil or capecitabine did not show a significant benefit in overall survival, progression-free survival, or response rate in patients with advanced gastric/GEJ cancer versus chemotherapy alone. However, there are several ongoing studies exploring immunotherapy in various lines of therapy.

Notably, investigators observed some benefit in patients who had a PD-L1 (combined positive score [CPS]) of ≥1; these patients experienced a better response with the addition of pembrolizumab to standard chemotherapy. Moreover, a subsequent analysis showed that patients with even higher scores—a CPS of 10—seemed to have even better outcomes with that type of therapy, concludes Davis.

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