Professor Jeroen Dekervel from UZ Leuven (Leuven, Belgium) and Dr Yelena Janjigian from Memorial Sloan Kettering Cancer Center (New York, USA), both specialized in gastric oncology, discuss the interim analysis of the MATTERHORN study.
The study, in which Dr. Janjigian is a prime investigator, explores the addition of durvalumab into FLOT therapy for locally advanced gastric cancers, including GI junction patients. This is a departure from the prevailing perioperative triplet therapy with FLOT and radiation-based treatments. In Asia, the approach differs, involving surgery followed by double chemotherapy.
The MATTERHORN trial was devised to combine a triplet regimen with durvalumab, an anti-PD-L1 agent, or a placebo. While immunotherapy is established and approved for metastatic cases, its efficacy in early stages is yet unproven. Given the inadequacy of surgery alone and the recurrence risks associated with FLOT therapy, this trial introduces immunotherapy into the early-stage treatment landscape on a global scale, encompassing patients worldwide.
Although the primary endpoint remains Event-Free Survival (EFS), the interim analysis presented data on pathological complete response (pCR). A notable 12% increase in pCR was observed. While this does not directly correlate with survival, the trial revealed a compelling 15% downstaging of node-negative cases in the group treated with durvalumab. This downstaging is associated with improved EFS.
In summary, the interim analysis of the MATTERHORN trial indicates that triplet therapy serves as a secure foundation. Additionally, the incorporation of durvalumab augments pCR rates without exacerbating the safety profile when compared to the placebo in patients suffering from advanced gastric cancer.
Reference:
Al-Batran S.-E. – Pathological complete response (pCR) to durvalumab plus 5-fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) in resectable gastric and gastroesophageal junction cancer (GC/GEJC): Interim results of the global, phase III MATTERHORN study. ESMO2023 – LBA73
With the educational support of:
 |
 |
 |