A recent study conducted at the Memorial Sloan Kettering Cancer Center in New York has revealed promising results for the treatment of advanced oesophagogastric adenocarcinoma. The combination of regorafenib, nivolumab, and chemotherapy has shown potential in improving survival rates and delaying disease progression.
Oesophagogastric cancer is a significant global health concern, ranking as the second-leading cause of cancer-related deaths. Approximately 1.3 million people succumb to this disease annually. A large proportion of patients are diagnosed at an advanced stage, where the disease has metastasised, making treatment more challenging.
Historically, the addition of nivolumab to chemotherapy has improved survival rates in patients with advanced oesophagogastric adenocarcinoma. However, outcomes remained suboptimal. The recent study aimed to assess the safety and efficacy of adding regorafenib to this combination.
Regorafenib, known for its potential in treating refractory oesophagogastric cancer, was combined with nivolumab (an anti-PD-1 antibody) and standard chemotherapy. The rationale behind this combination was to enhance the overall efficacy of the treatment.
The trial enrolled 39 patients, of which 35 were evaluated for 6-month progression-free survival. At this milestone, 25 patients (71%) were progression-free, surpassing the historically derived control rate of 53%. This result indicates a significant improvement in delaying disease progression.
However, like all treatments, there were side effects. The most common adverse event reported was fatigue, affecting 92% of patients. Serious adverse events were noted in 26% of participants, including acute kidney injury, hepatotoxicity, and sepsis. Importantly, there were no treatment-related deaths.
The findings of this study, titled “First-line regorafenib with nivolumab and chemotherapy in advanced oesophageal, gastric, or gastro-oesophageal junction cancer in the US: a single-arm, single-centre, phase 2 trial,” were published in The Lancet Oncology. The results suggest that the combination of regorafenib, nivolumab, and chemotherapy is not only safe but also exhibits anti-tumour activity in patients with advanced oesophagogastric cancer.
Given the positive outcomes of this phase 2 trial, researchers are now planning a randomised phase 3 clinical trial to further evaluate the treatment’s efficacy and safety on a larger scale.
This combination treatment offers a glimmer of hope for patients with advanced oesophagogastric adenocarcinoma, a disease that has historically been challenging to treat effectively.