Immunotherapy represents a new solution in cancers of the esophagus in advanced stage
Published the 05.12.2017 at 11h31
cancer of the œsophageimmunothérapiesanti-PD1
Patients with advanced cancer of the esophagus or gastroesophageal junction esophageal usually have a poor prognosis and the current recommendations do not offer any specific treatment in this case.
Immunotherapy anti-PD1 would represent a new opportunity for these patients according to a placebo-controlled trial that was published in The Lancet.
Patients in treatment failure
A group of researchers has evaluated the effectiveness and safety of immunotherapy, nivolumab, a monoclonal antibody anti-PD-1 in patients with advanced cancer of the esophagus or gastroesophageal junction esophageal failure of at least 2 chemotherapy regimens.
To do this, patients with this type of cancer, and intolerant of standard treatment or to other therapeutic antibodies acting on the regulation of T lymphocytes have been recruited. They have been drawn at random in 2 groups : the first group received 3 mg/kg of nivolumab and the 2nd group received a placebo intravenously every 2 weeks.
The study treatment was continued until disease progression according to the investigator, or the appearance of toxicities requiring a final judgment.
The nivolumab raises hope
Neither the patients nor the researchers were aware of the treatment they received. The primary endpoint was overall survival in the population intent-to-treat. Safety was analyzed in all patients who received at least one dose of study treatment.
The doubling of the overall survival in the group nivolumab monotherapy (at 26.2 months, compared with 10, 6 months in the placebo group), shows that the nivolumab, or another inhibitor of PD1/PDL1, could be a new treatment option in patients with advanced cancer of the esophagus or gastroesophageal junction esophageal. The tolerance observed in this population of patients is consistent to what has been observed in other studies of nivolumab on other cancers, and no new toxicity compared to what is known.
This study has resulted in the launch of other studies with nivolumab in cancer of the esophagus or gastroesophageal junction esophageal in different configurations, in association to chemotherapy, and to earlier stages of cancer.