P1351 - Efficacy of Nivolumab for Advanced Refractory Esophageal and Gastro-Esophageal Junction Cancer: Systemic Review and Meta-Analysis

Tian Li, MD, MS¹, Yuntao Zou, MD², Yiting Li, MD³, Frank Friedenberg, MD, MS (Epi)^4
1SUNY Downstate Health Science University, Brooklyn, NY; ²Saint Peter's University Hospital, New Brunswich, NJ; ³University of New Mexico, Albuquerque, NM; ⁴Temple University Hospital, Philadelphia, PA

Introduction: Recently Nivolumab, a fully human IgG4 monoclonal antibody inhibitor of programmed death-1, was studied as adjuvant treatment for patients with advanced esophageal or gastro-esophageal junction (GEJ) cancer while taking or after taking standard therapy, chemoradiotherapy or surgery. Our study aimed to evaluate the efficacy of Nivolumab for advanced refractory esophageal or GEJ cancer.

Methods: MEDLINE, the Cochrane Library, and EMBASE were searched up to 6/1/2021. The following

keywords were used either alone or in combination: Nivolumab, esophageal cancer, esophagus cancer. Observational studies and clinical trials that utilized Nivolumab for refractory esophageal cancer were included. Overall survival, progression-free survival, and objective response, including complete response, partial response, stable disease and progressive disease were studied as primary outcomes. Data were analyzed with STATA version 16.0 (Stata Corp, College Station, TX, USA).

Results: A total of 264 manuscripts were identified and five observational or clinical studies including 515 patients met inclusion criteria. Patient median ages were more than 60 in all 5 studies and 367 (71.3%) were male. For patients with advanced esophageal or GEJ cancer undergoing nivolumab treatment, the overall survival rate at 12 and 24 months were 36% (95% confidence interval (CI) 28–48%) and 9% (95% CI 5-18%). The progression-free survival rate at 12 months was 10% (95% CI 7-13%). The objective response rate (complete response and partial response) was 18% (95% CI 15-22%), the stable disease rate was 22% (95% CI 18-26%), the progressive disease rate was 53% (95% CI 48-57%).

Discussion: In our meta-analysis, nivolumab demonstrates clinical meaningful survival benefits and might serve as an appealing treatment option for patients with advanced refractory esophageal or GEJ cancer. Further randomized double blinded studies with larger population and diverse background are warranted.


Figure: Figure 1. Overall survival rate, progression-free survival rate, objective response rate, stable disease rate, and progressive disease rate for patients receiving nivolumab


Disclosures:
Tian Li indicated no relevant financial relationships.
Yuntao Zou indicated no relevant financial relationships.
Yiting Li indicated no relevant financial relationships.
Frank Friedenberg indicated no relevant financial relationships.


Tian Li, MD, MS¹, Yuntao Zou, MD², Yiting Li, MD³, Frank Friedenberg, MD, MS (Epi)⁴. P1351 - Efficacy of Nivolumab for Advanced Refractory Esophageal and Gastro-Esophageal Junction Cancer: Systemic Review and Meta-Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.