Nivolumab plus chemotherapy or ipilimumab in the first-line palliative therapy of esophageal, gastroesophageal junction, and gastric cancer
Abstract
Patients with advanced and/or metastatic upper gastrointestinal (GI) tract cancers still have a dismal prognosis. Despite the use of palliative chemotherapy, most patients will die within one year after diagnosis and long-term disease control is rare.
Therapy with immune checkpoint inhibitors has been evaluated in various solid tumors, including the upper GI tract cancers. Nivolumab, a monoclonal antibody targeting the PD-1 receptor, in combination with anti-CTLA-4 monoclonal antibody ipilimumab or chemotherapy demonstrated efficacy in patients with advanced nonresectable and/or metastatic squamous cell esophageal cancer (CheckMate 648 trial).
Further, nivolumab in combination with chemotherapy demonstrated efficacy in patients with esophageal, gastroesophageal junction, and gastric adenocarcinoma (CheckMate 649 trial). The present article conveys the results of said clinical trials and discusses the role of nivolumab as a first-line palliative therapy for upper GI tract cancer.