First-line nivolumab plus chemotherapy for advanced gastroesophageal adenocarcinoma: 3-year follow-up of CheckMate 649

The multinational phase 3 CheckMate 649 trial randomized patients with previously untreated advanced gastroesophageal adenocarcinoma to nivolumab plus chemotherapy or chemotherapy alone. Results of the trial with minimum 36.2 months follow-up have now been published. The figure shows that both among patients with PD-L1 combined positive score ≥ 5 (A, C, E) and among all randomized patients (B, D, and F) addition of nivolumab to first-line chemotherapy was associated with longer overall survival (A, B) and progression-free survival (C, D), and longer duration of response (E, F). The HRs for OS consistently favored nivolumab plus chemotherapy over chemotherapy alone across multiple prespecified subgroups among patients with PD-L1 CPS ≥ 5 and in the overall population. The safety profile was acceptable. The authors conclude that these results support the continued use of nivolumab plus chemotherapy as standard first-line treatment for advanced gastroeosphageal adenocarcinoma.