Low survival, limited treatment options in patients with a positive PD-L1 score1-12
In certain unresectable, advanced or metastatic, upper GI cancers,
Despite treatment advances in recent years, key outcomes of 1L treatment success remain low and limited in phase 3 clinical trials with previously approved PD-1–inhibitor and chemotherapy combinations as well as for chemotherapy alone.
In 1L ESCC:
- Less than 14 months mOS in patients with a positive PD-L1 score receiving immunotherapy and chemotherapy combinations, or chemotherapy alone, in phase 3 clinical trials*
- Patients with advanced or metastatic ESCC also face debilitating symptoms, such as dysphagia, which can lead to cachexia
In 1L GC/GEJC:
- 14 months or less mOS in patients with a positive PD-L1 score receiving immunotherapy and chemotherapy or chemotherapy alone in pivotal trials†
- Despite the difficulty in detecting widespread disease, it is estimated that ~50% of patients present with peritoneal metastases. It is difficult for patients with peritoneal metastases to remain on treatment, and no phase 3 trial of immunotherapy has reported favorable survival using a PD-L1 score cutoff of ≥1%,‡ potentially owing to the immunosuppressive, macrophage-rich environment in the peritoneum
Patients with advanced or metastatic upper GI cancers need 1L treatment options that can extend survival further and bring more life to the table for patients
*Phase 3 clinical trials include CHECKMATE-648, KEYNOTE-590, and REAL-2. Median overall survival of less than 14 months represents analyses of patients with CPS scores ≥1.
†Pivotal trials include CHECKMATE-649, KEYNOTE-859, and REAL-2. Median overall survival of 14 months or less represents analyses of patients with CPS scores ≥1.
‡Phase 3 clinical trials include ATTRACTION-04, CHECKMATE-649, and KEYNOTE-859.
1L, first line; CPS, combined positive score; ESCC, esophageal squamous cell carcinoma; GC, gastric cancer; GEJC, gastroesophageal junction cancer; GI, gastrointestinal; PD-1, programmed death receptor 1; PD-L1, programmed death ligand 1.
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