Dr. Sanjeevaiah on the Benefit of Immunotherapy Agents in Gastric Cancers

Aravind R. Sanjeevaiah, MD, an assistant professor in the Department of Internal Medicine at The University of Texas Southwestern Medical Center, discusses the benefit of immunotherapy agents in the treatment of patients with gastric cancers.

Many immunotherapy agents have been examined in gastric and gastroesophageal junction (GEJ) adenocarcinoma, including nivolumab (Opdivo) and pembrolizumab (Keytruda), according to Sanjeevaiah. The first practice-changing study with immunotherapy was the phase 2 KEYNOTE-058 trial (NCT02335411) with single-agent pembrolizumab, in which the agent demonstrated benefit in metastatic gastric and GEJ cancer.

The benefit was particularly significant in patients with PD-L1–positive disease in the third-line setting, which is the indication in which the agent was approved by the FDA in September 2017. Since the approval, data from the phase 3 CheckMate-649 trial (NCT02872116) has read out, demonstrating that for patients with a combined positive score of 5 or more, at the introduction of nivolumab plus 5-fluorouracil, leucovorin, and oxaliplatin, results in a significant clinical benefit in terms of overall survival. These data have also been practice changing for this patient population, Sanjeevaiah concludes.