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Standard first-line chemotherapy for HER2-negative, PDL1-positive metastatic esophagogastric cancer includes an immune checkpoint inhibitor. Standard chemotherapy at progression is paclitaxel and ramucirumab. Investigators in Italy now report results of the industry-supported, open-label, randomized, phase 3 ARMANI trial comparing continuation of first line FOLFOX or capecitabine oxaliplatin to an early therapy change to paclitaxel/ramucirumab in 280 patients with metastatic, HER2-negative esophagogastric adenocarcinoma who had achieved disease control (45% stable disease, 41% partial response) after 3 months of initial chemotherapy. No patient received an immune checkpoint inhibitor.
At a median follow-up of 44 months, the primary endpoint …