Reported by Dr Eduard Callebout – University Hospital Gent, Belgium
The advanTIG trial aimed to assess the impact of adding ociperlimab (OCI) to the standard care regimen of tislelizumab (TIS) + BAT1706 (a bevacizumab biosimilar) in advanced hepatocellular carcinoma. The primary objective was to determine the objective response rate. Unfortunately, the trial did not demonstrate any significant increase in response. However, it’s crucial to note that ongoing trials might shed more light on this combination. Therefore, conclusions cannot be drawn definitively at this point.
In the context of colon carcinoma, resistance tends to develop after a few months of treatment with FGFR inhibitors. The study examined tinengotinib, a next-generation FGFR inhibitor potentially capable of overcoming this resistance. Results from this phase 1-2 trial showed a favourable overall objective response rate (ORR) and a 6-month progression-free survival (PFS) across all groups. Notably, even patients who had previously progressed on FGFR inhibitors exhibited positive responses. Additionally, the safety profile of tinengotinib was superior to that of first-line FGFR inhibitors, suggesting its potential significance as a future therapeutic option.
Two trials focused on peri-operative interventions for gastric and gastroesophageal functional adenocarcinoma. The RESOLVE trial explored the benefits of perioperative chemotherapy in patients with advanced gastric cancer, demonstrating improved 5-year overall survival. Consequently, perioperative chemotherapy has become the new standard of care for these patients in Asian countries. Building on this, the DRAGON-4 trial combined perioperative SOX with antiangiogenic drugs and a checkpoint inhibitor, aiming to achieve pathological complete response (pCR) and event-free survival (EFS). While pCR increased by 13%, its impact on EFS remains uncertain pending further data.
Furthermore, studies incorporating immune checkpoint inhibitors into first-line chemotherapy reinforced the notion that PDL-1 blockade offers significant benefits for advanced gastric and gastroesophageal cancer. The NO LIMIT trial specifically investigated nivolumab and ipilimumab in patients with MSI-H metastatic gastric cancer, revealing promising outcomes, including a 60% objective response rate, an 80% disease control rate, and a 14-month progression-free survival. This study emphasizes the potential of immune checkpoint inhibitors as first-line treatments for these patients, corroborating earlier retrospective findings.
Finally, updates from phase 3 trials, namely the SPOTLIGHT and the GLOW trial, were presented. Both trials targeted claudin-18 isoform 2-positive (CLDN18.2+) adenocarcinoma with zolbetuximab. An extended 8-month follow-up did not yield substantial new findings; progression-free survival and overall survival rates remained elevated, and no new safety concerns arose. Notably, the 2-year overall survival rate was nearly 30% in both studies, comparable to outcomes seen with chemotherapy and immune checkpoint inhibitors. An intriguing avenue for further exploration lies in studying the effects of an anti-claudin antibody in conjunction with a checkpoint inhibitor, a combination currently under investigation in the ILUSTRO trial.
References:
Ming Mo Hou – AdvanTIG-206: Phase 2 Randomized Open-Label Study of Ociperlimab (OCI) + Tislelizumab (TIS) + BAT1706 (Bevacizumab Biosimilar) Versus TIS + BAT1706 in Patients (pts) With Advanced Hepatocellular Carcinoma (HCC) – ESMO 2023 – 945MO
Meredith S. Pelster – Tinengotinib in Patients with Advanced, Fibroblast Growth Factor Receptor (FGFR) inhibitor Refractory/Relapsed Cholangiocarcinoma – ESMO 2023 – 95MO
Xiaotian Zhang – Overall Survival of Perioperative or Postoperative Adjuvant Oxaliplatin with S-1 versus Adjuvant Oxaliplatin with Capecitabine in Locally Advanced Gastric or Gastro-Oesophageal Junction Adenocarcinoma Undergoing D2 Gastrectomy: An Updated Analysis of RESOLVE Trial – ESMO 2023 – LBA78
Chen Li – Perioperative camrelizumab (C) combined with rivoceranib (R) and chemotherapy (chemo) versus chemo for locally advanced resectable gastric or gastroesophageal junction (G/GEJ) adenocarcinoma: the first interim analysis of a randomized, phase 3 trial (DRAGON IV) – ESMO 2023 – 1512MO
Kei Muro – A Phase II study of Nivolumab plus low dose Ipilimumab as 1st line therapy in patients with advanced gastric or esophago-gastric junction MSI-H tumor: First results of the NO LIMIT study – ESMO 2023 – 1513MO
Florian Lordick – Updated efficacy and safety results from phase 3 GLOW study evaluating zolbetuximab + CAPOX as first-line (1L) treatment for patients with claudin-18 isoform 2-positive (CLDN18.2+), HER2−, locally advanced (LA) unresectable or metastatic gastric or gastroesophageal junction (mG/GEJ) adenocarcinoma – ESMO 2023 – LBA81
Affer A. Ajani – Updated efficacy and safety results from phase 3 SPOTLIGHT study evaluating zolbetuximab + mFOLFOX6 as first-line (1L) treatment for patients with claudin-18 isoform 2-positive (CLDN18.2+), HER2−, locally advanced (LA) unresectable or metastatic gastric or gastroesophageal junction (mG/GEJ) adenocarcinoma – ESMO 2023 – LBA82
With the educational support of:
 |
 |