Dr. Rajdev on the Efficacy of Pembrolizumab/Chemotherapy in Esophageal Cancer

Lakshmi Rajdev, MD, director of GI Malignancies, Western Region for Northwell Health; chief of division for Hematology/Oncology, Department of Medicine, at Lenox Hill Hospital; and an associate professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, discusses the efficacy of pembrolizumab (Keytruda) plus chemotherapy in patients with esophageal cancer.

Results from the phase 3 KEYNOTE-590 trial (NCT03189719) demonstrated that the chemoimmunotherapy approach improved response rates, progression-free survival, and overall survival over chemotherapy alone in patients with advanced esophageal cancer, Rajdev says. These benefits were observed regardless of combined positive score (CPS), Rajdev adds. The patients who derived the greatest benefit from this approach were those with squamous cell carcinoma and a CPS of greater than 10, Rajdev notes.

Notably, 26% of patients on the study presented with adenocarcinoma, and approximately half of the patients had a CPS of 10 or greater, according to Rajdev. Considering the number of patients who had a CPS that was greater than or equal to 10, this regimen could potentially be applied to all patients with esophageal cancer, according to Rajdev. Although this regimen could represent a new standard of care, it remains to be seen how regulatory agencies will indicate who should receive this treatment, Rajdev concludes.