Avelumab is in clinical development for gastric or gastro-oesophageal cancer. Gastric cancer is cancer that starts anywhere inside the stomach or the stomach wall. Advanced gastric cancer can be locally advanced (has spread into the tissues around the stomach) or metastatic (has spread to at least one other part of the body such as the liver). Advanced or metastatic cancers have poor prognosis and often have no cure (surgically), but treatment may control further growth of the disease, relieve symptoms and give the patient a good quality of life. Treatment strategy often involve an induction phase to preserve patient quality of life and a maintenance phase to prolong treatment benefit.
Avelumab is a human monoclonal antibody designed to recognise and attach to a protein called ‘programmed death-ligand-1’ (PD-L1). PD-L1 is a protein produced by several cancers and prevents the activation of T cells, which are part of the body’s immune (defence) system. Avelumab blocks PD-L1 which prevents the cancer cells from switching off the T cells, increasing the ability of the T cells to kill the cancer cells. Early results have shown that avelumab was well tolerated and showed promising clinical activity with good response rate when given as first line maintenance in patients with advanced or metastatic gastric or gastro-oesophageal junction cancer.
Nivolumab in combination with cisplatin and fluorouracil is in clinical development for patients with unresectable, advanced, recurrent or metastatic oesophageal squamous cell cancer cell carcinoma. Advanced oesophageal cancer begins in the food pipe and spreads to other parts of the body. Squamous cell cancers develop from the cells that make up the inner lining of the oesophagus. Symptoms include difficulty swallowing, persistent acid indigestion or heartburn, weight loss, pain in the throat, and chronic cough. Lifestyle factors are attributed to most oesophageal cancers, including smoking and being overweight.