Would you consider adjuvant nivolumab to be the standard of care in stage II/III esophageal/GE junction cancer after completion of neoadjuvant chemoradiotherapy and surgery?
Is DFS endpoint sufficient to establish SOC or is OS benefit needed?
Answer from: Medical Oncologist at Community Practice
Patients with gastric or GEJ adenocarcinoma who achieve a pCR following preoperative therapy still have a significant risk of recurrence and cancer-specific death following resection. Although recurrence at 5 years can be significantly lower for pCR vs non-pCR patients (27% and 51%), the probability...
Answer from: Medical Oncologist at Academic Institution
Yes, in May 2021, the Food and Drug Administration (FDA) approved nivolumab for patients with completely resected esophageal or gastroesophageal junction cancer with residual pathologic disease who have received neoadjuvant chemoradiotherapy. The European Medicines Agency (EMA) also approved adjuvan...
Comments
Medical Oncologist at Huntsman Cancer Institute, University of Utah Dr. @Kelly - would you offer adjuvant nivolum...
Answer from: Medical Oncologist at Academic Institution
Yes, I would consider nivolumab the new SOC in esophageal/GEJ cancer after trimodality therapy in patients with residual disease in the path specimen (i.e. those without a complete path CR). The DFS benefit with nivolumab was substantial in these patients, and this is the first large randomized stud...
Comments
Medical Oncologist at Delray Medical Center Yes- I agree. I think the other issues that come i...
Answer from: Medical Oncologist at Academic Institution
Yes, I would consider this the standard-of-care. And, clearly, I'm not some unconventional rebel here since adjuvant nivolumab in this context is FDA approved and also endorsed by the NCCN!
The premise of the question is an important one though: is a DFS benefit only, while OS data are maturing, su...