What are your considerations for choice of immunotherapy agent with patients with metastatic pMMR HER2- esophageal/GEJ/gastric adenocarcinoma with CPS >=10?
Are there meaningful differences in the CHECKMATE 649 and KEYNOTE 590 studies to guide this decision?
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What is your preferred initial systemic therapy for a fit patient with metastatic pMMR HER2- esophageal/GEJ/gastric adenoca w/ CPS >= 10%?
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2 Answers
Mednet Member
Medical Oncology · New York Presbyterian/Weill Cornell Medical Center
Answered on
I alluded to this earlier. Although both CheckMate 649 and KEYNOTE 590 included esophageal cancer, there were caveats. Specifically, in CheckMate 649, there were relatively few patients with esophageal adenocarcinoma. The positive results of CM-649 were clearly driven by gastric adenocarcinoma, part...
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Mednet Member
Medical Oncology · NYU School of Medicine
Answered on
There are no meaningful differences in CheckMate 649 (nivolumab + chemotherapy) and KEYNOTE 590 for patients whose CPS >=10. Either regimens are reasonable choices as both improve OS, PFS, and ORR compared to chemotherapy.
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