Dr. Mehta on Immunotherapy in Gastric/GEJ Cancer

Rutika Mehta, MD, MPH
Published: Thursday, Mar 21, 2019



Rutika Mehta, MD, MPH, gastrointestinal medical oncologist at Moffitt Cancer Center, discusses the use of immunotherapy in patients with gastric or gastroesophageal junction (GEJ) adenocarcinoma.

In the KEYNOTE-059 trial, patients who had progressed on 2 prior lines of therapy received pembrolizumab (Keytruda) monotherapy in the third-line setting. The agent resulted in an improvement in overall survival (OS), as well as an overall response rate of 13.3% in patients with PD-L1 positivity, says Mehta. These results served as the basis for the September 2017 FDA approval for use in this patient subset. Subsequently, results from the phase III KEYNOTE-061 study were announced. For this trial, investigators randomized patients to receive either pembrolizumab or paclitaxel. However, the trial failed to result in an improvement in OS or progression-free survival.

However, a subgroup analysis revealed that some subgroups showed benefit with the PD-1 inhibitor. This benefit was specific to patients with microsatellite instability-high tumors, as well as those with a CPS of ≥10 in the PD-L1–positive population, says Mehta. Although it is not recommended to use pembrolizumab in the second-line, a small subset of patients may derive benefit from the drug in that setting.
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Rutika Mehta, MD, MPH, gastrointestinal medical oncologist at Moffitt Cancer Center, discusses the use of immunotherapy in patients with gastric or gastroesophageal junction (GEJ) adenocarcinoma.

In the KEYNOTE-059 trial, patients who had progressed on 2 prior lines of therapy received pembrolizumab (Keytruda) monotherapy in the third-line setting. The agent resulted in an improvement in overall survival (OS), as well as an overall response rate of 13.3% in patients with PD-L1 positivity, says Mehta. These results served as the basis for the September 2017 FDA approval for use in this patient subset. Subsequently, results from the phase III KEYNOTE-061 study were announced. For this trial, investigators randomized patients to receive either pembrolizumab or paclitaxel. However, the trial failed to result in an improvement in OS or progression-free survival.

However, a subgroup analysis revealed that some subgroups showed benefit with the PD-1 inhibitor. This benefit was specific to patients with microsatellite instability-high tumors, as well as those with a CPS of ≥10 in the PD-L1–positive population, says Mehta. Although it is not recommended to use pembrolizumab in the second-line, a small subset of patients may derive benefit from the drug in that setting.



View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Oncology Briefings™: Individualizing Treatment After Second-Line Therapy for Patients With mCRCAug 29, 20191.0
Community Practice Connections™: Navigating New Sequencing Challenges for the Treatment of Hepatocellular CarcinomaAug 30, 20191.5
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