Andrew Ko, MD, professor, Department of Medicine, University of California, San Francisco Helen Diller Comprehensive Cancer Center, discusses exciting data from the 2018 Gastrointestinal Cancers Symposium.

The greatest interest is in immune-oncology agents. As physicians eagerly anticipate the impact of a number of these drugs, an important take-home message is to be more circumspective. Ko suggests to not automatically assume that these agents can and should be moved to earlier-line settings.

However, a number of studies are looking at moving these targeted agents to first-line treatment as well as the perioperative setting. In the adjuvant setting, CheckMate-577 is looking at nivolumab (Opdivo) as an adjuvant treatment following chemoradiation and surgery for resectable esophageal and gastroesophageal junction cancers.

Physicians need to figure out what to do with patients who have gone to surgery, but were found to have residual pathologic disease at the time of surgery. CheckMate-577 might reveal that the use of some of these novel agents, like immunotherapy, may at some point find their place in earlier-stage settings. Until those results are revealed, physicians should be hesitant about using them in these contexts, says Ko.

Andrew Ko, MD

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Dr. Ko Discusses the CheckMate-577 Trial