Supplement Durvalumab to the Standard FLOT Chemotherapy for Resectable Gastric and Gastroesophageal Adenocarcinoma
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on August 4th, 2025
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Gastric and gastroesophageal adenocarcinoma is one of the most common cancers in Vietnam. Surgical resection with chemotherapy is the ideal way to treat the tumor; however, recurrence is still high. Interfering with the tumor’s immunosuppressive effect had been found to be effective at disease management. A study funded by AstraZeneca was conducted to analyze the addition of durvalumab to the standard chemotherapy to manage gastric and gastroesophageal cancer.
The phase 3 clinical trial included 948 participants who had been diagnosed with resectable gastric or gastroesophageal adenocarcinoma. Most of the patients have tumors at stage 3, with around one-quarter having more advanced stage 4 tumors. The patients were randomly assigned to be treated with either placebo or durvalumab on top of the standard chemotherapy regimen of fluorouracil, leucovorin, oxaliplatin, and docetaxel. Durvalumab was given intravenously at a dose of 1500 mg every 4 weeks. The medication works by interfering with the interaction between PD-1 and PD-L1 that tumors utilize to suppress clearance by the immune system.
After 2 years, the researchers found that the addition of durvalumab significantly increased the survival rate and reduced disease progression by 29%. Additionally, the immune reactivation effect of durvalumab achieved a complete tumor removal in 19.2% of the patients, more than the 7.2% observed in the placebo group. This result is consistent with other trials that examine the addition of other anti-PD-1 agents such as nivolumab or pembrolizumab.
The phase 3 clinical trial included 948 participants who had been diagnosed with resectable gastric or gastroesophageal adenocarcinoma. Most of the patients have tumors at stage 3, with around one-quarter having more advanced stage 4 tumors. The patients were randomly assigned to be treated with either placebo or durvalumab on top of the standard chemotherapy regimen of fluorouracil, leucovorin, oxaliplatin, and docetaxel. Durvalumab was given intravenously at a dose of 1500 mg every 4 weeks. The medication works by interfering with the interaction between PD-1 and PD-L1 that tumors utilize to suppress clearance by the immune system.
After 2 years, the researchers found that the addition of durvalumab significantly increased the survival rate and reduced disease progression by 29%. Additionally, the immune reactivation effect of durvalumab achieved a complete tumor removal in 19.2% of the patients, more than the 7.2% observed in the placebo group. This result is consistent with other trials that examine the addition of other anti-PD-1 agents such as nivolumab or pembrolizumab.