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Nivolumab in previously treated advanced gastric cancer (ATTRACTION-2): 3-year update and outcome of treatment beyond progression with nivolumab

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Abstract
Background: ATTRACTION-2 demonstrated that nivolumab improved overall survival (OS) vs placebo in patients with advanced gastric cancer treated with ≥ 2 chemotherapy regimens. However, its long-term efficacy and outcome of treatment beyond progression (TBP) with nivolumab have not been clarified.

Methods: The 3-year follow-up data were collected. A subset analysis was performed to explore the efficacy of TBP by assessing postprogression survival (PPS) after the first event of disease progression.

Results: Overall, 493 patients were randomized (2:1) to receive nivolumab (n = 330) or placebo (n = 163). With a median follow-up of 38.5 (range 36.1-47.5) months, OS of the nivolumab group was significantly longer compared to the placebo group (median 5.3 vs 4.1 months; 3-year survival rate, 5.6% vs 1.9%; hazard ratio [HR], 0.62 [95% confidence interval (CI) 0.50-0.75], P < 0.0001). The median OS of responders (n = 32) who achieved complete response or partial response was 26.7 months and the 3-year survival rate was 35.5% in the nivolumab group. Overall, 109 patients in the nivolumab group and 37 patients in the placebo group received TBP. PPS tended to be longer in the nivolumab group vs placebo group (median 5.8 vs 4.5 months; HR [95% CI], 0.69 [0.47-1.01], P = 0.057). In contrast, PPS was similar between both treatment groups in non-TBP patients (median 2.3 vs 2.2 months; HR 0.90, P = 0.42).

Conclusions: Long-term efficacy of nivolumab was confirmed at the 3-year follow-up, and a survival benefit of TBP with nivolumab was suggested. Biomarkers for selecting patients suitable for TBP with nivolumab should be identified in the future.
Author(s)
· Li?Tzong Chen· Li?Yuan Bai1· Taihei Nishiyama강윤구유민희Do?Youn OhHyun Cheol ChungJae Yong ChoJen?Shi ChenJong Gwang KimKei MuroKeiko MinashiKeisho ChinKen KatoKeun?Wook LeeKun?Huei YehMasahiro TsudaNarikazu BokuSang Cheul OhTakaki YoshikawaTakao TamuraTaroh SatohWon Ki K
Issued Date
2021
Type
Article
Keyword
ATTRACTION-2Gastric or gastroesophageal junction cancerLong-term efficacyNivolumabTreatment beyond progression
DOI
10.1007/s10120-021-01173-w
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8404
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8205916&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Nivolumab%20in%20previously%20treated%20advanced%20gastric%20cancer%20(ATTRACTION-2):%203-year%20update%20and%20outcome%20of%20treatment%20beyond%20progression%20with%20nivolumab&amp;offset=0&amp;pcAvailability=true
Publisher
GASTRIC CANCER
Location
일본
Language
영어
ISSN
1436-3291
Citation Volume
24
Citation Number
4
Citation Start Page
946
Citation End Page
958
Appears in Collections:
Medicine > Medicine
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