Immunotherapy in Gastric Cancer—Choosing Methods or Results
Mené en France sur 96 patients atteints d'un adénocarcinome de l'estomac ou de la jonction oesogastrique de stade avancé (âge médian : 59,7 ans), cet essai multicentrique de phase II évalue l'efficacité, du point de vue de la survie sans progression à 4 mois, et la toxicité d'une chimiothérapie de deuxième ligne de type FOLFIRI combinée au durvalumab avec ou sans trémélimumab
Although its value was rapidly recognized in the treatment of other cancers, immunotherapy with immune checkpoint inhibitors (ICIs) has achieved slower success in the treatment of gastric and gastroesophageal adenocarcinoma. After mixed results in second-line, third-line therapy, and beyond when given as single agent, it has now been adopted in combination with cytotoxic chemotherapy in first-line treatment thanks to clinically and statistically significant improvements in various outcomes: overall survival (OS), disease-free survival (DFS), and response rate (RR). In the quest to identify predictive factors of benefit, a few biomarkers have emerged, the most useful of which seems to be combined positive score (CPS), that is, programmed death-ligand 1 (PD-L1) expression on both tumor cells and cells of the tumor microenvironment. Of note, it has superseded tumor positive score (TPS), which is PD-L1 expression limited to tumor cells.