ASCO GI 2022 | Immune checkpoint inhibitors and combination strategies for patients with gastric cancer

Sun Young Rha, MD, PhD, Yonsei Cancer Center, Seoul, South Korea, emphasizes the significance of immunotherapy and combination strategies to treat patients with gastric cancer (GC). Nivolumab has previously demonstrated modest activity in the later line of treatment for GC and only in a small proportion of patients. Dr. Rha explains how treating patients with immunotherapy as a monotherapy often results in primary resistance and early tumor progression, providing the rationale for treatment with a combination strategy. The Phase III CheckMate649 (NCT02872116) clinical trial demonstrated some impressive responses when investigating immune checkpoint inhibitors plus chemotherapy as first-line treatment for prespecified subgroups patients with GC or gastroesophageal junction (GEJ) cancer. Additionally, anti-PD-1 and anti-CTLA-4 have been investigated in patients with GC which revealed an issue with high rates of toxicity due to anti-CTLA-4, thus an upcoming trial is investigating a proper dosing schedule for this combination. Further, angiogenesis plays a significant role in the oncogenesis of GC, providing the rationale for exploring the combination of multitarget kinase angiogenesis inhibitors with pembrolizumab or nivolumab. The combination of regorafenib plus nivolumab or lenvatinib plus pembrolizumab demonstrated potential in the treatment of GC. Additionally in development and currently in the area of clinically translatable data is the combination of an anti-cancer vaccine with immunotherapy as well as CAR-T cells. This interview took place at the American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium.