Long-term survival outcomes with perioperative avelumab and chemotherapy for gastroesophageal adenocarcinoma

Neoadjuvant chemoimmunotherapy is a promising strategy for locally advanced gastroesophageal adenocarcinoma (GEA); little is known, however, about its long-term impact on survival. Post hoc analysis of a phase 2 trial at McGill University Health Centre (Montreal, Canada) evaluated long-term survival outcomes with perioperative avelumab and chemotherapy for GEA. Fifty patients received 4 neoadjuvant cycles of avelumab-docetaxel-cisplatin-fluorouracil (aDCF), followed by resection and 4 adjuvant aDCF cycles. Forty-nine patients (98%) completed neoadjuvant aDCF. All patients proceeded to surgery, with major pathological response (MPR) in nine patients (18%). The median follow-up of the cohort was 71.5 months (range 43-105) with median disease-free survival and median overall survival of 61.0 months and 77.0 months, respectively, and 5-year DFS and OS of 50% and 60%. Among patients with MPR, 5-year DFS and OS were 100%. There were no new safety signals. The authors conclude that perioperative aDCF is a feasible regimen for patients with locally advanced GEA.