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Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Addition of Bemarituzumab to mFOLFOX in FGFR2b-Selected Gastric or Gastroesophageal Junction Adenocarcinoma

In the phase II FIGHT trial reported in The Lancet Oncology, Zev A. Wainberg, MD, and colleagues found numerically better progression-free survival with the addition of the anti-FGFR2b antibody bemarituzumab to mFOLFOX (modified fluorouracil, leucovorin, and oxaliplatin) in patients with...

Gastroesophageal Cancer
Genomics/Genetics

Genetic Variation May Explain Racial Disparity in Esophageal Cancer Cases

Esophageal adenocarcinoma is a type of cancer affecting the mucus-secreting glands of the lower esophagus and is the most common form of esophageal cancer. It is often preceded by Barrett’s metaplasia, a deleterious change in cells lining the esophagus. Though the cause of esophageal adenocarcinoma ...

Gastroesophageal Cancer
Immunotherapy

Is PD-L1 Expression a Good Predictor of Survival Benefit in Patients With Advanced Gastroesophageal Cancer Treated With Immunotherapy?

In a systematic review and meta-analysis of phase III trials of immune checkpoint inhibitor treatment in patients with advanced gastroesophageal cancer reported in JAMA Oncology, Harry H. Yoon, MD, MS, and colleagues found that PD-L1 expression was the strongest predictor of overall survival...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Neoadjuvant Nivolumab Plus Ipilimumab in Localized dMMR/MSI-H Gastric Cancer

As reported in the Journal of Clinical Oncology by Thierry André, MD, and colleagues, the French (GERCOR) phase II NEONIPIGA trial has shown a high pathologic complete response rate with nivolumab/ipilimumab neoadjuvant therapy in patients with localized deficient mismatch repair...

Gastroesophageal Cancer

RATIONALE-306: Survival Benefit Attained With Tislelizumab in Advanced Esophageal Cancer

In patients with advanced or metastatic esophageal squamous cell carcinoma, the addition of the checkpoint inhibitor tislelizumab to first-line chemotherapy significantly improved overall survival vs chemotherapy alone, according to an interim analysis of the global phase III RATIONALE-306 trial....

Gastroesophageal Cancer

Early Research Finds Link May Connect Cell-Signaling Pathway to Development of Esophageal Cancers, Barrett’s Esophagus

A team of researchers believe they have identified a cell-signaling pathway responsible for the development of esophageal adenocarcinomas, an aggressive type of esophageal cancer that has gradually become more common, even in younger people. Research published by Venkitachalam et al in...

Gastroesophageal Cancer
Immunotherapy

Trastuzumab and Nivolumab Plus Either Ipilimumab or FOLFOX as First-Line Treatment for HER2-Positive Advanced Esophagogastric Adenocarcinoma

As reported in JAMA Oncology by Stein et al, the German phase II INTEGA trial showed improved survival with the addition of modified FOLFOX6 (fluorouracil, leucovorin, oxaliplatin) vs the addition of ipilimumab to trastuzumab/nivolumab in the first-line treatment of patients with advanced or...

Gastroesophageal Cancer
Immunotherapy

Addition of Trastuzumab/Pertuzumab to Perioperative FLOT Chemotherapy in HER2-Positive Esophagogastric Adenocarcinoma

In the German phase II PETRARCA trial of the AIO EGA Study Group, reported in the Journal of Clinical Oncology, Hofheinz et al found that the addition of trastuzumab and pertuzumab to perioperative FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) improved both the pathologic complete...

Gastroesophageal Cancer

Nivolumab in Combination With Chemotherapy and in Combination With Ipilimumab in Advanced Esophageal Squamous Cell Carcinoma

On May 27, 2022, nivolumab was approved for use in combination with fluoropyrimidine- and platinum-based chemotherapy and in combination with ipilimumab for the first-line treatment of advanced or metastatic esophageal squamous cell carcinoma.1 Supporting Efficacy Data Approval was based on...

Gastroesophageal Cancer
Immunotherapy

FDA Approves Two Nivolumab-Based Regimens as First-Line Treatments for Unresectable Advanced or Metastatic Esophageal Squamous Cell Carcinoma

On May 27, 2022, the U.S. Food and Drug Administration (FDA) approved the following for the first-line treatment of patients with advanced or metastatic esophageal squamous cell carcinoma: Nivolumab (Opdivo) in combination with fluoropyrimidine- and platinum-based chemotherapy Nivolumab in...

Gastroesophageal Cancer

Rise of Esophageal Cancer and Barrett’s Esophagus Rates in Middle-Aged Adults

Adults aged 45 to 64 years experienced a nearly doubled rate of esophageal cancer and a 50% increase in the precancerous condition Barrett’s esophagus between 2012 and 2019, according to a database analysis of roughly 5 million patients presented by Qumseya et al at Digestive Disease Week 2022...

Gastroesophageal Cancer
Immunotherapy

PD-1 Inhibition in First-Line Treatment of Advanced Esophageal Squamous Cell Carcinoma: More to Come on New Paradigm

Esophageal cancer is associated with significant morbidity and mortality worldwide, with more than 600,000 new cases and 540,000 deaths in 2020. The squamous cell histology comprises nearly 90% of cases globally, despite its steady decline in the United States over the past 40 years. Historically,...

Gastroesophageal Cancer
Immunotherapy

Overall Survival Benefit With Nivolumab Plus Chemotherapy or Ipilimumab vs Chemotherapy Alone in Esophageal Squamous Cell Carcinoma

As reported in The New England Journal of Medicine by Yuichiro Doki, MD, of Osaka University Graduate School of Medicine, Japan, and colleagues, the phase III CheckMate 648 trial has shown improved overall survival with nivolumab combined with chemotherapy or ipilimumab vs chemotherapy alone in...

Gastroesophageal Cancer
COVID-19

Delays in Surgery for Advanced Esophageal Cancer Result in Significantly Worse Survival

Delays in surgery for esophageal cancer did not appear to have much impact on patients’ relative survival for early-stage cancer compared with patients who had surgery early, but they did reduce the relative survival rate by almost half for patients with more advanced disease, according to an...

Gastroesophageal Cancer
Immunotherapy

Second-Line Tislelizumab vs Chemotherapy for Advanced Esophageal Squamous Cell Carcinoma

In the phase III RATIONALE-302 trial reported in the Journal of Clinical Oncology, Shen et al found that the anti–PD-1 antibody tislelizumab significantly improved overall survival vs chemotherapy in the second-line treatment of patients with advanced or metastatic esophageal squamous cell...

Gastroesophageal Cancer
Genomics/Genetics

Study Identifies Genetic Changes in Patients With Barrett’s Esophagus That Progresses to Esophageal Cancer

Using whole-genome sequencing to contrast genomic alterations in patients with stable Barrett’s esophagus compared to patients whose Barrett’s progressed to esophageal adenocarcinoma, Paulson et al reported that DNA changes presaging esophageal cancer can be spotted years before cancer develops....

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Gulam A. Manji, MD, PhD, on Gastric and Gastroesophageal Junction Adenocarcinomas: New Data on Pembrolizumab Plus Capecitabine and Oxaliplatin

Gulam A. Manji, MD, PhD, of Columbia University Medical Center, discusses phase II results on perioperative combination chemotherapy and pembrolizumab in patients with resectable gastric cancer. The combination appeared to result in many complete pathologic responses (Abstract CT009).

Hepatobiliary Cancer
Gastroesophageal Cancer
Genomics/Genetics

Assessment of Cancer Risk Profile for Germline BRCA1 and BRCA2 Pathogenic Variants in Patients With Common Cancers

In a Japanese case-control study reported in JAMA Oncology, Momozawa et al found that germline BRCA1/2 pathogenic variants were associated with an increased risk of biliary tract, esophageal, and gastric cancers, in addition to an increased risk of cancers that have well-established associations...

gastroesophageal cancer

Zev Wainberg, MD, on Gastroesophageal Junction Adenocarcinoma: Early Results With Anti-CD39 Antibody Plus Chemoimmunotherapy

Zev Wainberg, MD, of the University of California, Los Angeles Medical Center, discusses preliminary data on the safety and efficacy of TTX-030, an anti-CD39 antibody, in combination with budigalimab and FOLFOX for the first-line treatment of locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma. The study suggests the regimen may prove to be of benefit as a first-line treatment, regardless of combined positive score status (Abstract CT015).

Gastroesophageal Cancer
Immunotherapy

EGFR Inhibition in EGFR-Amplified Advanced Gastroesophageal Cancer

As reported in the Journal of Clinical Oncology by Maron et al, a retrospective study found that use of EGFR inhibitor therapy was associated with benefit in patients with unresectable or metastatic EGFR-amplified gastroesophageal adenocarcinoma. As stated by the investigators, “Subset analyses...

Gastroesophageal Cancer

Adjuvant Nivolumab Improves Disease-Free Survival vs Placebo in Resected Esophageal or Gastroesophageal Junction Cancer After Neoadjuvant Chemoradiotherapy

As reported in The New England Journal of Medicine by Ronan J. Kelly, MB BCh, MBA, of The Charles A. Sammons Cancer Center at Baylor University Medical Center, and colleagues, an interim analysis of the phase III CheckMate 577 trial has shown a significant improvement in disease-free survival with ...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

KEYNOTE-811: Pembrolizumab Plus Trastuzumab and Chemotherapy in Previously Untreated Advanced HER2-Positive Gastric Adenocarcinoma

As reported in Nature by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center, and colleagues, the first interim analysis of the phase III KEYNOTE-811 trial has shown a significantly higher objective response rate with the addition of...

Colorectal Cancer
Hepatobiliary Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Recent FDA Approvals in Gastrointestinal Cancer

Over the past year, the U.S. Food and Drug Administration granted approval to several novel drugs and new indications for older therapeutic agents used in gastrointestinal oncology. Cetuximab Plus Encorafenib On September 28, 2021, cetuximab (Erbitux) was approved in combination with encorafenib...

Gastroesophageal Cancer
Immunotherapy

Expert Point of View: Samuel J. Klempner, MD

Samuel J. Klempner, MD, Associate Professor at Massachusetts General Hospital and Harvard Medical School, commented on the NEONIPIGA study for The ASCO Post. “This study was the first prospective data set to show what many have suspected—that neoadjuvant immune checkpoint blockade would lead to a...

Gastroesophageal Cancer
Immunotherapy

Neoadjuvant Checkpoint Inhibitor Doublet Yields Complete Responses in Gastroesophageal Cancers

In patients with resectable microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) gastric and gastroesophageal junction adenocarcinoma, dual checkpoint inhibition with ipilimumab and nivolumab given as neoadjuvant therapy led to a pathologic complete response rate of 58.6%,...

Gastroesophageal Cancer
Immunotherapy

Adding Pembrolizumab to Chemotherapy Improves Overall and Progression-Free Survival in First-Line Treatment of Advanced Esophageal Cancer

As reported in The Lancet by Jong-Mu Sun, MD, of Samsung Medical Center, Sungkyunkwan University, Seoul, and colleagues, an interim analysis in the phase III KEYNOTE-590 trial has shown that the addition of first-line pembrolizumab to chemotherapy resulted in improved overall and progression-free...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Adding First-Line Nivolumab to Chemotherapy Improves Survival in Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinomas

As reported in The Lancet by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Expert Point of View: Stefano Cascinu, MD

Stefano Cascinu, MD, of the Comprehensive Cancer Center, Università Vita-Salute, IRCCS-Ospedale San Raffaele, Milan, Italy, was the invited discussant of KEYNOTE-5901 and CheckMate 649.2 “These landmark studies could change the treatment paradigm of advanced esophageal and gastric cancers. They...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Checkpoint Inhibitors in Esophagogastric Cancer: Updates of Landmark Trials

Updates of landmark trials of immune checkpoint inhibitors as first-line therapy for advanced HER2-negative esophagogastric cancers were presented at the 2022 ASCO Gastrointestinal Cancers Symposium. The studies upheld previous findings of an overall survival benefit when these agents are paired...

Gastroesophageal Cancer
Immunotherapy

Expert Point of View: Samuel J. Klempner, MD

Samuel J. Klempner, MD, Associate Professor at Massachusetts General Hospital and Harvard Medical School, commented on the NEONIPIGA study for The ASCO Post. “This study was the first prospective data set to show what many have suspected—that neoadjuvant immune checkpoint blockade would lead to a...

Gastroesophageal Cancer
Immunotherapy

Neoadjuvant Checkpoint Inhibitor Doublet Yields Complete Responses in Gastroesophageal Cancers

In patients with resectable microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) gastric and gastroesophageal junction adenocarcinoma, dual checkpoint inhibition with ipilimumab and nivolumab given as neoadjuvant therapy led to a pathologic complete response rate of 58.6%,...

Gastroesophageal Cancer
Colorectal Cancer
Gastrointestinal Cancer
Immunotherapy

Updated Findings on T-DXd in Gastrointestinal Malignancies

Updates of phase II studies evaluating fam-trastuzumab deruxtecan-nxki (T-DXd) in gastrointestinal cancers were presented at the 2022 ASCO Gastrointestinal Cancers Symposium, continuing to offer support for the antibody-drug conjugate in these malignancies. In HER2-expressing gastric cancer, T-DXd...

Gastroesophageal Cancer

Pretreatment Cardiovascular Disease and Events in Patients Receiving Curative-Intent Chemoradiation for Esophageal Cancer

In a Danish single-institution study reported in JACC: CardioOncology, Mette Marie A. Søndergaard, MD, of the Department of Cardiology, Aarhus University Hospital, Denmark, and colleagues found a high rate of undetected or inadequately treated preexisting cardiovascular disease (CVD) prior to...

Gastroesophageal Cancer
Immunotherapy

CheckMate 648: Nivolumab Plus Chemotherapy or Ipilimumab vs Chemotherapy in Previously Untreated Advanced Esophageal Squamous Cell Carcinoma

As reported in The New England Journal of Medicine by Doki et al, the phase III CheckMate 648 trial has shown improved overall survival with nivolumab combined with chemotherapy or ipilimumab vs chemotherapy alone in patients with previously untreated advanced esophageal squamous cell carcinoma, in ...

gastroesophageal cancer
immunotherapy

Thierry André, MD, on Esophagogastric Adenocarcinoma: New Findings on Nivolumab and Ipilimumab

Thierry André, MD, of Sorbonne University and Saint-Antoine Hospital, discusses phase II results from the GERCOR NEONIPIGA study, which suggests neoadjuvant therapy with nivolumab and ipilimumab may be associated with a high pathologic complete response rate in patients with localized microsatellite instability–high or mismatch repair–deficient esophagogastric adenocarcinoma. This study raises the question of whether surgery could be delayed or avoided for some patients (Abstract 244).

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Zev A. Wainberg, MD, on Gastric or Gastroesophageal Junction Adenocarcinoma: Follow-up Data on Pembrolizumab and Chemotherapy

Zev A. Wainberg, MD, of the University of California, Los Angeles, discusses an update, of 25 additional months, on phase III safety and efficacy results from the KEYNOTE-062 trial. This study compared pembrolizumab with or without chemotherapy vs chemotherapy alone for patients with PD-L1–positive advanced gastric or gastroesophageal junction adenocarcinoma (Abstract 243).

Gastroesophageal Cancer
Immunotherapy

Addition of Perioperative Trastuzumab to Neoadjuvant Chemoradiation for Patients With HER2-Overexpressing Esophageal Adenocarcinoma

As reported in The Lancet Oncology by Howard P. Safran, MD, and colleagues, the phase III NRG Oncology/RTOG-101 trial has shown no significant disease-free survival benefit with the addition of perioperative trastuzumab to neoadjuvant chemoradiation in previously untreated patients with...

Gastroesophageal Cancer
Immunotherapy

Pembrolizumab Plus Chemotherapy in Advanced Esophageal Cancer: Good News for Some, but More Work to Be Done

Multiple comparisons of traditional cytotoxic chemotherapy combinations that began decades ago led to the adoption of the platinum plus fluorouracil doublet as the standard of care for treatment of recurrent or metastatic esophageal cancer.1 Other combinations created by the addition and/or...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Kohei Shitara, MD, on Gastric and Esophageal Cancers: Long-Term Follow-up on Nivolumab Plus Chemotherapy

Kohei Shitara, MD, of Japan’s National Cancer Center Hospital East, discusses a long-term data follow-up from CheckMate 649, which support the continued use of nivolumab plus chemotherapy as first-line treatment in patients with advanced gastric, gastroesophageal junction, and esophageal adenocarcinomas (Abstract 240).

Gastroesophageal Cancer

Pretreatment Cardiovascular Disease and Events During Follow-up in Patients Receiving Curative-Intent Chemoradiation for Esophageal Cancer

In a Danish single-institution study reported in JACC: CardioOncology, Søndergaard et al found a high rate of undetected or inadequately treated preexisting cardiovascular disease prior to the receipt of chemoradiation and a high rate of cardiovascular events during follow-up in patients undergoing ...

Gastroesophageal Cancer

Long-Term Swallowing Quality-of-Life Results With Radiotherapy vs Transoral Robotic Surgery for Oropharyngeal Cancer

In a long-term longitudinal analysis of the phase II ORATOR trial reported in the Journal of Clinical Oncology, Anthony Nichols, MD, and colleagues found that a statistically significant improvement in swallowing quality of life persisted through 3 years after treatment with radiotherapy vs...

Gastroesophageal Cancer

Selecting Patients With Barrett's Esophagus for Endoscopic Surveillance: Role of Nonendoscopic Device Biomarkers

In a study reported in The Lancet Oncology, Pilonis et al found that nonendoscopic cell collection device (marked as the Cytosponge)–detected atypia and p53 overexpression could be used in combination with clinical risk factors to triage patients with Barrett’s esophagus for endoscopic...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Addition of Nivolumab to Oxaliplatin-Based Chemotherapy for HER2-Negative, Unresectable, Advanced or Recurrent Gastric or Gastroesophageal Junction Cancer

In an Asian phase II/III trial (ATTRACTION-4) reported in The Lancet Oncology, Yoon-Koo Kang, MD, and colleagues found that the addition of nivolumab to oxaliplatin-based chemotherapy improved progression-free survival—but not overall survival—as first-line treatment of HER2-negative, unresectable, ...

Gastroesophageal Cancer

New Research Aims to Uncover Cellular Source of Barrett’s Esophagus

Two recent studies correct a long-standing misconception about the origins of Barrett’s esophagus and, in doing so, may point to new avenues of treatment or prevention to lower the risk of esophageal cancer. The first study, published by Singh et al in the journal Gastroenterology, demonstrated...

Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Study Suggests Lack of Benefit With the Addition of Immune Checkpoint Inhibition to Chemotherapy in Low PD-L1–Expressing Gastric or Esophageal Adenocarcinoma

In an analysis reported in the Journal of Clinical Oncology, Zhao et al found that the addition of an immune checkpoint inhibitor to chemotherapy in trials of first-line treatment of advanced gastric or esophageal adenocarcinoma was not associated with benefit in low PD-L1–expressing subgroups not...

Gastroesophageal Cancer
Immunotherapy

Health-Related Quality of Life With Pembrolizumab vs Chemotherapy for Advanced Esophageal Cancer

In a study reported in the Journal of Clinical Oncology, Adenis et al found that health-related quality of life was maintained with both pembrolizumab and chemotherapy in the pivotal phase III KEYNOTE-181 trial, which included patients with advanced esophageal cancer who had received previous...

Skin Cancer
Gynecologic Cancers
Prostate Cancer
Breast Cancer
Solid Tumors
Hepatobiliary Cancer
Gastroesophageal Cancer
Immunotherapy

FDA Pipeline: Recent Reviews, Designations, Applications, and Authorizations in the Oncology Space

Over the past month, the U.S. Food and Drug Administration (FDA) issued several regulatory decisions for novel treatments for patients with cancer. Priority Review for Relatlimab and Nivolumab Fixed-Dose Combination in Unresectable or Metastatic Melanoma The FDA accepted for Priority Review the...

Gastroesophageal Cancer

Nivolumab Plus Chemotherapy Improves Survival in Advanced Gastric and Esophageal Adenocarcinomas: Now to Figure Out the Details in These Heterogeneous Diseases

There is no doubt that subsets of patients with esophageal and gastric cancers benefit from immune checkpoint inhibitor therapy. The complexity lies in identifying the appropriate histology, tumor location, expression of programmed cell death receptors and ligands, mechanism of checkpoint...

Gastroesophageal Cancer

Adding First-Line Nivolumab to Chemotherapy Improves Survival in Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinomas

As reported in The Lancet by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and...

Gastrointestinal Cancer
Immunotherapy
Gastroesophageal Cancer

DESTINY-Gastric02: Fam-Trastuzumab Deruxtecan-nxki Produces Responses in Patients With HER2-Positive Gastric Cancers

In the primary analysis of the phase II DESTINY-Gastric02 trial, fam-trastuzumab deruxtecan-nxki (T-DXd) produced clinically meaningful and durable responses in Western patients with advanced HER2-positive gastric or gastroesophageal junction cancers whose disease had progressed after a...

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