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    Home > Active Ingredient News > Antitumor Therapy > J Clin Oncol: Neoadjuvant Nivolumab/Ipilimumab + Adjuvant Nivolumab in dMMR/MSI-H Gastric/Gastroesophageal Junction Adenocarcinoma

    J Clin Oncol: Neoadjuvant Nivolumab/Ipilimumab + Adjuvant Nivolumab in dMMR/MSI-H Gastric/Gastroesophageal Junction Adenocarcinoma

    • Last Update: 2022-10-15
    • Source: Internet
    • Author: User
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    For patients with resectable gastric/gastroesophageal junction (GEJ) adenocarcinoma, the standard of care is surgery plus perioperative platinum-based chemotherapy
    However, perioperative chemotherapy remains controversial for mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) gastric/GEJ adenocarcinomas

    The NEONIPIGA trial is a phase 2 study evaluating nivolumab (240 mg/2 weeks*6 times) + ipilimumab (1 mg/kg 6 weeks*2 times) neoadjuvant therapy, followed by surgery and adjuvant nivolumab (480 mg/4 weeks)
    The primary endpoint was pathological complete response (pCR) rate

    Between October 2019 and June 2021, a total of 32 patients with dMMR/MSI-H gastric/GEJ adenocarcinoma were recruited, with a median age of 65.
    5 years (range: 40-80 years)
    Clinical stages were cT2-T3N0 (n=9), cT2-T3N1 (n=22) and cT3N1M1 (n=1)

    Treatment Response for Each Patient

    With a median follow-up of 14.
    9 months, 32 patients received neoadjuvant therapy (27 completed all courses of therapy)
    Neoadjuvant therapy-related grade 3-4 adverse events occurred in 6 (19%) patients
    Twenty-nine patients underwent surgery; 3 did not, with complete remission on endoscopy, no tumor biopsy, and normal computed tomography (two refused surgery and one had metastases at the time of inclusion)

    Adverse reactions

    All 29 patients achieved R0 resection, and 17 (58.
    6%) achieved pathological complete remission (pathological T0N0)
    Of the 29 patients who underwent surgery, 23 received adjuvant nivolumab
    At the time of analysis, no patients had relapsed and one patient died (not the cause of relapse)

    In conclusion, for patients with dMMR/MSI-H resectable gastric/gastroesophageal junction adenocarcinoma, nivolumab- and ipilimumab-based neoadjuvant therapy is feasible, with a high pathological complete response rate and no Unexpected toxicity


    Original source:

    Thierry André, et al.
    Neoadjuvant Nivolumab Plus Ipilimumab and Adjuvant Nivolumab in Localized Deficient Mismatch Repair/Microsatellite Instability-High Gastric or Esophagogastric Junction Adenocarcinoma: The GERCOR NEONIPIGA Phase II Study.
    Journal of Clinical Oncology.
    August 13, 2022.
    https:// ascopubs.

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