Nivolumab (also known as Opdivo and made by Bristol Myers Squibb) given alongside chemotherapy has been recommended as an option for untreated HER2-negative, advanced or metastatic gastric, gastro-oesophageal junction or oesophageal adenocarcinoma if the tumours express PD-L1.
Clinical evidence shows nivolumab with chemotherapy increases the time before the cancer gets worse and increases life expectancy. The treatment could mean that 8 per cent of people achieve long-term remission compared to 4 per cent currently.
Nivolumab is a targeted immunotherapy designed to recognise and attach to a specific protein called programmed death-1 receptor (PD-1). This protein can shut off the body’s immune system. By attaching to PD-1, nivolumab blocks its action and allows the body’s immune system to continue to attack the gastric, oesophageal or gastro-oesophageal junction cancer cells.
Cancer cells that are HER2 negative may grow more slowly and are less likely to come back or spread to other parts of the body than cancer cells that have a large amount of HER2.
Helen Knight, interim director of medicines evaluation at NICE, said: “The combination of nivolumab plus chemotherapy not only has the potential to slow the disease down and extend life for people with these forms of cancer, but there is some promise of long-term remission.
“We know there is a significant impact on the quality of life for people with these forms of advanced cancer and therefore I’m delighted that we have been able to recommend this innovative treatment for people with these rare forms of gastroesophageal cancer.
“We are determined to drive ground-breaking treatments such as this into the hands of health and care professionals.”
When Nivolumab is given in combination with chemotherapy for the treatment of advanced gastric, gastro-oesophageal junction or oesophageal adenocarcinoma, the recommended dose is 360 mg every 3 weeks or 240 mg every 2 weeks.
Gastroesophageal cancer includes tumours found anywhere in the oesophagus, sometimes called the gullet or foodpipe, the stomach and where the oesophagus meets the stomach.