Positive results following trial of pembrolizumab on GI patients

The KEYNOTE-059 trial is one of the largest ongoing studies that is particularly concentrated on investigating immunotherapy in gastric cancer.

The researchers found that after six-months the overall response rate from those treated with pembrolizumab in the study was 12%.

On further analysis, the results suggested that patients who showed signs of programmed death-ligand 1 (PD-L1) were more likely to respond to the use of pembrolizumab.

Speaking on the study, Dr. Zev Wainberg, co-director of the Gastrointestinal Oncology Programme at UCLA, said:  

“The data shows that the tumours were sufficiently shrunk to warrant a response, particularly in those patients who had PD-L1 expression, and the drug was safe. The expected response rate in these heavily pre-treated patients was close to zero so the findings are encouraging.”

“These results have set the stage for a larger follow-up study which is already enrolling patients. We hope these results, in combination with evidence from ongoing randomised trials, will support the regulatory approval of pembrolizumab in metastatic gastric cancer.”

Dr. Ian Chau, consultant medical oncologist at Royal Marsden Hospital, also said:

“There is currently no standard of care for metastatic gastric cancer treated in the third line or beyond. The KEYNOTE-059 cohort 1 results confirm that the efficacy previously reported for the PD-1 inhibitor nivolumab in patients from East Asia in the ONO-4538 randomised trial can be applied to Western populations.”

“The likelihood is that pembrolizumab will become a standard treatment option in this setting in the near future.’

However, Dr. Chau heeded caution, suggesting:

“Unlike with chemotherapy, toxicities from immunotherapy tend to occur later on. We need to await longer-term results from an ongoing clinical trial in an earlier line of treatment to know the full impact of this drug in metastatic gastric cancer. Further research should focus on refining the PD-L1 biomarker and searching for better biomarkers to tell us who benefits from these therapies. We also need more information about the quality of life which should be provided by ongoing studies.”

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