Multinational phase 3 trial of perioperative durvalumab in gastric and gastroesophegeal junction adenocarcinoma

Perioperative FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) is a standard therapy for resectable gastric and gastroesophageal junction (G/GEJ) adenocarcinoma, but recurrence rates remain high. The multinational phase 3 MATTERHORN trial evaluated perioperative durvalumab plus FLOT versus placebo plus FLOT. The durvalumab group had https://www.nejm.org/pb-assets/images/editorial/large/NEJMoa2503701_600x400-1748634288193.jpg significantly better event-free survival compared with the placebo group. Two-year overall survival was 75.7% in the durvalumab group and 70.4% in the placebo group (piecewise HR for death during months 0 to 12, 0.99, and during the period from month 12 onward, 0.67. Percentage of patients with pathological complete response was 19.2% in the durvalumab group and 7.2% in the placebo group (RR 2.69; 95% CI 1.86-3.90). Durvalumab was well tolerated well.