Nivolumab with or without chemotherapy for metastatic gastroesophageal cancers and future perspectives

ABSTRACT

Introduction

Gastroesophageal cancers (GEC) are frequently found at the advanced stage. GEC treatment advancements have been limited and prognosis, therefore, remains poor. Through numerous clinical trials, the addition of immune checkpoint inhibitors, including nivolumab, to conventional therapy has demonstrated a survival benefit.

Areas covered

Here, we focus on the function of nivolumab in patients with advanced GECs. We discuss the most recent trials that led to nivolumab’s incorporation into therapy and pathways forward.

Expert opinion

Nivolumab in combination with chemotherapy appears well tolerated, with only a small number of patients reporting severe toxicity; therefore, it may be possible to add additional biological agents to improve outcomes. A number of ‘nivolumab plus other agents’ is currently being investigated, and we anticipate continued advancement in GEC management in the coming years.

KEYWORDS:

• Checkpoint inhibitor
• Gastroesophageal Cancer
• immunotherapy
• nivolumab
• PD-1
• PD-L1
• pembrolizumab

Article highlights

• Following the findings of CHECKMATE-649 and CHECKMATE-648, nivolumab in combination strategies has been designated to the first-line treatment of advanced GECs.

• Nivolumab is making a difference in the first-line therapy of GEC patients.

• Next-generation sequencing and circulating tumor DNA/liquid biopsies will almost certainly lead to the discovery of more actionable targets.

• Patients with locoregional and metastatic cancers continue to have suboptimal outcomes and further advances are needed.

• Enrollment in clinical trials and research specimen collection for in-depth analyses is highly desired.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper received no funding.