Adding First-Line Nivolumab to Chemotherapy for Gastroesophageal Adenocarcinoma

Until recently, median survival for metastatic gastric cancer treated with chemotherapy was less than 1 year. A series of recent randomized trials, however, have demonstrated improved survival with immune checkpoint inhibitors, advancing them to first-line therapy. Investigators now report the results of CheckMate 649, an industry-sponsored, open-label, international, randomized, phase 3 trial comparing standard FOLFOX (folinic acid, fluorouracil, and oxaliplatin) or capecitabine/oxaliplatin chemotherapy with or without the addition of nivolumab for adenocarcinoma of the stomach and gastroesophageal junction (GEJ). Of the 1581 patients randomized, 61% had programmed cell death-ligand 1 combined positive scores (CPS) ≥5, 70% had gastric and …