AACR 2022: Phase II trial of perioperative pembrolizumab in combination with capecitabine and oxaliplatin and adjuvant pembrolizumab in resectable gastric and gastroesophageal junction (GC/GEJ) adenocarcinoma

At the 2019 ASCO meeting, the latest results of the KEYNOTE-062 study were announced, including 763 patients with locally advanced, HER2-negative, unresectable or metastatic GC/GEJC with PD-L1 CPS ≥ 1, and patients with PD-L1 CPS ≥ 1.

Updated results from the ASCO KEYNOTE-062 study, including 763 patients with locally advanced, HER2-negative, PD-L1 CPS ≥ 1, unresectable or metastatic GC/GEJC, among patients with PD-L1 CPS ≥ 1, pembrolizumab Monoclonal antibody single-agent OS was non-inferior to chemotherapy; in patients with PD-L1 CPS ≥ 10, although pembrolizumab achieved a clinically meaningful OS improvement compared to chemotherapy, its combination with chemotherapy compared Chemotherapy alone was used as first-line treatment for advanced GC/GEJC, and no improvement in progression-free survival (PFS) or OS was observed

Perioperative treatment is the standard of care for the treatment of locally advanced (LA) GC/GEJ adenocarcinoma

This is a multicenter, single-arm, phase II clinical trial of pembrolizumab 200 mg every 3 weeks combined with capecitabine 625 mg/m2 twice daily and Thaliplatin 130 mg/m2 every 3 weeks (CAPOX)

Between February 10, 2017, and June 17, 2021, 36 patients were enrolled, of whom 34 (21 gastric, 13 GEJ) were eligible for efficacy evaluation

At the time of data cutoff, the median follow-up time was 19 months

The 1- and 2-year survival rates were 91% (0.

In conclusion, in LA GC/GEJ adenocarcinoma, the combination of CAPOX and pembrolizumab resulted in a pCR rate of 20.
6%
.
The combination was well tolerated, with 85.
3% of patients undergoing surgical resection
.
The trial met its primary endpoint, supporting further study of this regimen as an alternative in patients who are unlikely to tolerate triple chemotherapy
.


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