Immunotherapy may play a role in the treatment of non-metastatic gastrointestinal cancer

Immunotherapy has altered the treatment of patients with stage 4 metastatic esophageal and gastric cancer. It has been shown that in patients with these malignancies, immunotherapy prolongs survival when patients ’tumors exhibit high expression of an immune-related protein called PD-L1.

Researchers are now investigating whether immunotherapy is beneficial patients who do not have 4 stages of metastatic disease. In these patients, the tumors did not spread to distant organs. A study highlighting this study is published in Clinical studies of cancer.

“The current standard of care for patients with non-metastatic gastrointestinal cancer includes preoperative chemotherapy plus radiation and subsequent surgical resection of the primary cancer and surrounding lymph nodes,” he says. Harry Yoon, MD, a medical oncologist from the Mayo Clinic Cancer Center. However, Dr. Yun notes that the incidence of cancer recurrence in these patients is high, and when the tumor returns, the cancer is usually not cured.

Dr. Yoon and colleagues conducted a clinical study to evaluate whether adding immunotherapy called pembrolizumab to standard chemoradiation and surgery for patients with gastroesophageal adenocarcinoma could increase the number of patients who survived complete tumor destruction at baseline. lymph nodes.

“Patients who experience this complete eradication appear to have a higher chance of treatment,” says Dr. Yoon. “We have found that the addition of immunotherapy increases the likelihood of complete destruction of the primary tumor and regional nodular metastases in a group of patients with high PD-L1 levels. ”

“If these results can be confirmed in a larger, separate clinical study, combining immunotherapy with standard chemotherapy and surgery could become the new standard for treating patients with nonmetastatic gastrointestinal cancer,” says Dr. Yoon.

Dr Yoon notes that a major national clinical study supported by the National Cancer Institute (EA2174) is testing a combination immunotherapychemoradiation and surgery in patients with nonmetastatic gastrointestinal cancer.