國家衛生研究院 NHRI:Item 3990099045/10839

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Title:	A Phase 3 Study of nivolumab (Nivo) in previously treated advanced gastric or gastroesophageal junction (G/GEJ) cancer: Updated results and subset analysis by PD-L1 expression (ATTRACTION-02)
Authors:	Boku, N;Kang, YK;Satoh, T;Chao, Y;Kato, K;Chung, HC;Chen, JS;Muro, K;Kang, WK;Yoshikawa, T;Oh, SC;Tamura, T;Lee, KW;Chen, LT
Contributors:	National Institute of Cancer Research
Abstract:	Background: Nivo monotherapy demonstrated its efficacy with manageable safety for G/GEJ cancer refractory or intolerant to standard chemotherapy at the primary analysis (ATTRACTION-02[ONO-4538-12]: ASCO-GI 2017, Kang YK et al. J Clin Oncol. 2017; 35 [suppl 4S abstract 2]). Here, we report updated results, and the relationship between efficacy of Nivo and PD-L1 expression levels. Methods: 493 patients(pts) aged ≥ 20 years with ECOG PS 0-1 and unresectable advanced or recurrent G/GEJ cancer after failure of two or more previous chemotherapy regimens were randomized in a 2:1 ratio to receive 3 mg/kg Nivo (N = 330) or placebo (N = 163) every 2 weeks until unacceptable toxicity or disease progression. The primary endpoint was overall survival (OS). The PD-L1 expression was assessed by immunohistochemistry (28-8 pharmDx assay). And updated results of the efficacy and safety were based on ≥ 1-year follow-up after last patient enrollment. Results: As of the data cut-off on February 25th 2017, one year after last patient enrollment, the median OS (mOS) was 5.32 months with Nivo versus 4.14 months with placebo (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.50-0.75; p < 0.0001). The OS rates were 46.4% (95% CI, 40.8-51.8) versus 34.7% (95% CI, 27.4-42.1) at 6 months and 27.6%(95% CI, 22.8-32.6) versus 11.6% (95% CI,7.2-17.1) at 12 months. Immunohistochemistry was performed for exploratory analyses of OS by PD-L1 status on pretreatment tumor biopsies obtained from 197 pts. In pts with PD-L1-positive (expression ≥1%) tumors, the mOS was 5.22 months in the Nivo (16 pts) versus 3.83 months in placebo (10 pts) (HR, 0.58; 95% CI, 0.24-1.38). In pts with PD-L1 negative (<1%) tumors, mOS was 6.05 months (115 pts) versus 4.19 months (52 pts) (HR, 0.70; 95% CI, 0.49-1.00), respectively. Conclusions: With minimum 1-year of follow-up, long-term survival benefit of nivolumab was confirmed for patients with advanced G/GEJ cancer. Although tumor samples were available only in 40% of all enrolled patients, Nivo demonstrated benefit irrespective of PD-L1 expression in the exploratory analysis.
Date:	2017-09
Relation:	Annals of Oncology. 2017 Sep;28(Suppl. 5):Meeting Abstract 617O.
Link to:	https://doi.org/10.1093/annonc/mdx369.001
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0923-7534&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000411324001132
Appears in Collections:	[Li-Tzong Chen] Conference Papers/Meeting Abstract

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