ATTRACTION-4: Nivolumab plus chemotherapy for gastric or gastroesophageal cancer

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Published: 22 Sep 2020
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Prof Narikazu Boku - National Cancer Center Hospital, Tokyo, Japan

Prof Narikazu Boku speaks to ecancer in an online interview for the virtual ESMO 2020 meeting about the ATTRACTION-4 study results.

The study is looking at nivolumab plus chemotherapy versus chemotherapy alone in patients with previously untreated advanced or recurrent gastric or gastroesophageal cancer.

Prof Boku reports that the study found nivolumab with chemotherapy achieved improved progression-free survival and overall response rate, although did not result in any significant improvement in overall survival.

Prof Boku also remarks on the real-world nivolumab safety data he presented following on from the ATTRACTION-2 study.

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ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content. 

I am a PI with the ATTRACTION-4 trial which compared chemo plus nivolumab versus chemo plus placebo as a first line treatment for advanced gastric cancer. This trial has two primary endpoints, one is PFS and the other is OS. In the protocol it was pre-specified that the objective of this study will be achieved if at least one of the two primary endpoints is met.

Over 700 patients were enrolled from Japan, Korea and Taiwan and background characteristics were well balanced between the two treatment arms. Then chemo plus nivolumab has shown a statistically significant improvement in progression free survival but not OS.

Chemo plus nivolumab also had shown a higher response rate compared to placebo plus chemo and the response duration was quite long. The toxicity was manageable.

So our conclusion is chemo plus nivolumab has a clinically meaningful improvement in the treatment of advanced gastric cancer. I hope in the near future nivolumab will be available in the first line treatment for advanced gastric cancer.

In another presentation at this ESMO meeting I reported the real-world data of nivolumab as a salvage line treatment for advanced gastric cancer. The response rate was about 10% and the toxicity profile is quite similar to the ATTRACTION-2 trial. So already in Japan nivolumab is available for the treatment of advanced gastric cancer. I believe it contributes to prolong the survival of gastric cancer patients and maintain their quality of life.

That’s all, thank you.