The efficacy of adjuvant nivolumab in resected esophageal or gastroesophageal junction cancers: A single-center real-life data experience.

Abstract

e16113 Background: Based on the CheckMate 577 study, one year of nivolumab treatment has become the standard for patients diagnosed with esophageal or gastroesophageal junction (GEJ) cancer who have residual tumors after neoadjuvant chemoradiotherapy and R0 resection. This study aims to evaluate real-life data on the effectiveness of adjuvant nivolumab therapy in this patient group. Methods: This study included patients diagnosed with stage II-III esophageal or GEJ cancer treated at Van Yuzuncu Yil University between 2020-2024. All patients underwent neoadjuvant chemoradiotherapy followed by R0 resection. Those with residual pathological tumor received adjuvant nivolumab. The neoadjuvant chemoradiotherapy regimen included weekly paclitaxel (50 mg IV, day 1) and carboplatin (AUC2 IV, day 1) for five weeks. Patients who were operable 6-8 weeks after treatment completion underwent R0 resection. Adjuvant nivolumab (240 mg every 2 weeks) was administered until recurrence or up to a maximum of one year. Data were analyzed retrospectively, focusing on disease-free survival (DFS) and overall survival (OS). Results: A total of 33 patients, including 14 males (40.4%) and 19 females (57.6%), were included. The median age at diagnosis was 56 (40-73) years. ECOG performance scores were 0 in 24 patients (72.7%) and 1 in 9 patients (27.3%). Patients received a median of 21 (2-24) nivolumab cycles, with a median follow-up duration of 23 (2-39) months. The median DFS was not reached, while the mean DFS was 26.6 ± 2.6 months (95% CI: 21.3-31.8). Similarly, the median OS was not reached, and the mean OS was 35.8 ± 2.8 months (95% CI: 30.4-41.2). Conclusions: The median follow-up time in this study is comparable to that of the CheckMate 577 trial, which reported a median DFS was 22.4 months (95% CI: 16.6-34.0). In the present study, the median DFS and OS durations could not be reached. The mean DFS and OS were 26.6 and 35.8 months, respectively. Our study is limited by its single-center and retrospective design; however, to the best of our knowledge, it is the first real-life data study conducted in this patient group. Additionally, its significance lies in being conducted in a region where esophageal and stomach cancers are endemic.