Dr. Kardosh Discusses Epacadostat in Gastric/GEJ Adenocarcinoma

Adel Kardosh, MD, postdoctoral medical fellow, oncology, Stanford Medicine, discusses epacadostat in gastric and gastroesophageal junction (GEJ) adenocarcinoma.

Epacadostat is a novel IDO inhibitor currently being evaluated in combination with pembrolizumab (Keytruda) in a phase II study of patients with metastatic or unresectable gastric/GEJ adenocarcinoma (NCT03196232). Preclinical data have shown that the inhibition of IDO is associated with immune regulation and increase in anergy. Pembrolizumab is currently approved for advanced gastric or GEJ adenocarcinoma whose tumors express PD-1, but chemotherapy remains standard in this population.

The trial in progress is a single-arm, phase II clinical trial enrolling 30 patients over 18 months. The primary endpoint is 6-month progression-free survival (PFS), and secondary endpoints include response rate, overall survival, safety, and efficacy. Eligible patients are those with adenocarcinoma of the distal esophagus, GEJ, or stomach; progression on at least 1 prior line of therapy for metastatic disease; ECOG performance status 0 or 1; and are willing to undergo 2 biopsies before and while on treatment.