Immunotherapy may play a role in the treatment of non-metastatic gastroesophageal cancer
Newswise – ROCHESTER, Minn. – Immunotherapy has transformed the treatment of patients with metastatic Stage 4 esophageal and stomach cancers. In patients with these malignancies, immunotherapy has been shown to prolong survival when patients’ tumors show high expression of an immune-related protein called PD-L1.
Researchers are currently studying whether immunotherapy benefits patients who do not have stage 4 metastatic disease. In these patients, the tumors have not spread to distant organs. A study highlighting this research is published in Clinical Cancer Research.
“The current standard of care for patients with nonmetastatic gastroesophageal cancer involves preoperative chemotherapy plus radiation therapy and subsequent surgical resection of the primary cancer and surrounding lymph nodes,” says Harry Yoon, MD, medical oncologist at Mayo Clinic Cancer Center. However, Dr. Yoon notes that the rate of cancer recurrence in these patients is high and if the tumor recurs, the cancer is usually not curable.
Dr. Yoon and colleagues performed a clinical trial to assess whether adding an immunotherapy called pembrolizumab to chemoradiotherapy and standard surgery for patients with gastroesophageal junction adenocarcinoma could increase the number of patients having undergone complete eradication of the tumor in the original site and in the nearby lymph nodes.
“Patients who undergo this complete eradication seem to have a greater chance of recovery,” says Dr. Yoon. “We found that the addition of immunotherapy appeared to increase the likelihood of complete eradication of the primary tumor and regional nodal metastases in the group of patients whose tumors expressed high levels of PD-L1.”
“If these results can be confirmed in a separate larger clinical trial, the combination of immunotherapy with chemoradiotherapy and gold standard surgery could become the new standard of care for patients with non-metastatic gastroesophageal cancer” , says Dr. Yoon.
Dr. Yoon notes that a large national clinical trial supported by the National Cancer Institute (EA2174) is testing the combination of immunotherapy, chemoradiotherapy and surgery in patients with non-metastatic gastroesophageal cancer. .
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