Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Better Overall Survival With Nivolumab VS. Chemo For Advanced ESCC

Key clinical point: Nivolumab was associated with improved OS vs. chemotherapy, in previously treated advanced ESCC.

Major finding: Median OS was 10.9 vs. 8.4 months with nivolumab vs. chemotherapy, respectively (hazard ratio, 0.77).

Study details: A randomized, open-label, phase 3 study of 419 patients.

Disclosures: ATTRACTION-3 was funded by Ono Pharmaceutical Co., in collaboration with Bristol-Myers Squibb. Dr. Cho reported relationships with Bristol-Myers Squibb, Ono Pharmaceutical, and others. He reported stock ownership and/or patents with TheraCanVac and Champions Oncology.


Cho B et al. ESMO 2019, Abstract LBA11.


Limited systemic therapy options exist for patients with metastatic and refractory squamous cell cancer of the esophagus. Currently, systemic chemotherapy is the standard of care for patients that are resistant to first line therapy. In the ATTRACTION-3 trial, Kato et al evaluated whether nivolumab is superior, compared with taxanes, in the second line setting. Nivolumab was associated with an improvement in overall survival by 2.5 months compared with taxanes. Of note, PD-L1 expression did not correlate with overall survival, suggesting that additional studies are needed to identify better biomarkers for response to immune checkpoint inhibitors.—Mark A. Klein, MD