New Immunotherapy Combinations for Patients with Oesophageal Cancer - European Medical Journal

New Immunotherapy Combinations for Patients with Oesophageal Cancer

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FINDINGS from a new Phase III study show promise for the dual approach of chemotherapy and immunotherapy as a first-line treatment for advanced oesophageal squamous cell carcinoma. This research was presented at the American Society of Clinical Oncology (ASCO) Gastrointestinal (GI) Cancers Symposium 2024, held in San Francisco, California, USA, from 18th–20th January 2024. PD-L1 in combination with TIGIT inhibitors and chemotherapy was found to prolong survival in a population of Asian patients with metastatic or locally advanced oesophageal squamous cell carcinoma.  

Oesophageal squamous cell carcinoma is currently the most common form of oesophageal cancer, with patients reportedly experiencing survival rates as low as 5%. Symptoms such as depression, weight loss, and difficulty swallowing significantly impact the lives of patients. Therefore, new treatment strategies are urgently needed. Chih-Hung Hsu, National Taiwan University Hospital, Taipei City, Taiwan, and colleagues conducted a double-blind, placebo-controlled study, ‘SKYSCRAPER-08’, comprised of 461 patients at 67 centres in mainland China, South Korea, Thailand, Taiwan, and Hong Kong. A combination of two existing immunotherapies, tiragolumab and atezolizumab, were given in combination with chemotherapy to 229 patients, whilst 232 patients received chemotherapy and placebo treatment.  

Results indicated improvement in median overall survival for those treated with tiragolumab, atezolizumab, and chemotherapy compared to those treated with chemotherapy alone, after a 6.5 month follow-up, and in progression-free survival after a 14.5 month follow-up. Whilst manageable, reported side effects from the tiragolumab, atezolizumab, and chemotherapy group included immune-mediated rash (38.6%), immune-mediated hepatitis (35.1%), immune-mediated hyperthyroidism (17.5%), infusion-related reaction (17.5%), and immune-related pneumonitis (7.5%).  

As the first Phase III study to explore this particular therapy combination, SKYSCRAPER-08 may improve treatment options for patients with advanced oesophageal squamous cell carcinoma. As a continuation, Hsu and colleagues look to test tiragolumab and atezolizumab as a maintenance therapy, with the aim of enhancing remission.  

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