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Nivolumab (Opdivo°) in advanced gastric or oesophageal cancer

 Marketing Authorisations   Nivolumab, a monoclonal antibody directed against PD-1, has been authorised for patients with metastatic or inoperable gastric or oesophageal adenocarcinoma or squamous cell carcinoma. In these situations, does nivolumab represent a therapeutic advance compared to the treatments already available, and, in particular, does it extend survival?
Full article (3 pages) available for download by subscribers

In patients with inoperable or metastatic squamous cell carcinomas of the oesophagus, based on a single clinical trial, nivolumab as first-line, add-on chemotherapy extends median survival by around 6 months when at least 1% of the tumour cells express PD-L1.

For oesophageal squamous cell carcinoma in other situations, and for patients with adenocarcinoma of the stomach or oesophagus, the added benefit provided by nivolumab, alone or combined with a fluoropyrimidine and a platinum compound, is unclear, and modest at best.

Nivolumab carries a risk of serious adverse effects, such as autoimmune disorders affecting numerous organs, allergies and infusion reactions.

©Prescrire 1 September 2023

Source: "Nivolumab (Opdivo°) in advanced gastric or oesophageal cancer" Prescrire International 2023; 32 (251): 201-203. Subscribers only.

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