Opdivo Improves Survival in Advanced Esophageal Cancer: ATTRACTION-3 Trial

On September 30, 2019, clinical results were announced for the ATTRACTION-3 Phase 3 clinical trial, evaluating the anti-PD-1 antibody Opdivo (Nivolumab) in patients with unresectable advanced or recurrent esophageal cancer who were refractory to or intolerant of fluoropyrimidine- and platinum-based chemotherapy.

Study Design: ATTRACTION-3 Trial

This international, multicenter, open-label trial randomized patients into two groups:

1. Opdivo Group: Nivolumab monotherapy.
2. Chemotherapy Group: Investigator's choice of Taxotere (docetaxel) or Paclitaxel.

The primary endpoint was overall survival (OS).

Key Survival Results

The trial demonstrated a significant survival benefit for Opdivo:

• Median Overall Survival: 10.9 months for Opdivo vs. 8.4 months for chemotherapy.
• Risk Reduction: Opdivo reduced the risk of death by 23% (Hazard Ratio [HR] = 0.77).
• 12-Month OS Rate: 47% (Opdivo) vs. 31% (Chemotherapy).
• 18-Month OS Rate: 31% (Opdivo) vs. 21% (Chemotherapy).

Importantly, the survival benefit of Opdivo was observed regardless of the patient's PD-L1 expression levels.

Efficacy and Safety

• Objective Response Rate (ORR): 19% for Opdivo vs. 22% for chemotherapy.
• Duration of Response: Significantly longer with Opdivo (6.9 months) compared to chemotherapy (3.9 months).
• Safety: Opdivo was better tolerated, with a Grade 3/4 adverse event rate of 18% compared to 63% in the chemotherapy group.

Conclusion

Dr. Byoung Chul Cho and colleagues concluded that Opdivo significantly improves overall survival compared to standard chemotherapy in patients with previously treated advanced esophageal cancer, with a more favorable safety profile. These results support Opdivo as a new second-line standard of care for this population.

Source: BMS Press Release - ATTRACTION-3 Trial Results

#EsophagealCancer #Opdivo #Nivolumab #ATTRACTION3 #Immunotherapy #CancerResearch

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