The following article features coverage from the ASCO Gastrointestinal Cancers Symposium 2021 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Nivolumab continued to show improved overall survival (OS) compared with chemotherapy in patients with unresectable advanced or recurrent advanced esophageal squamous cell carcinoma (ESCC), according to research reporting results of the randomized, open-label phase 3 ATTRACTION-3 study.

At last data cut-off, 3 years after the last patient was enrolled, the median overall survival was 10.91 months with nivolumab compared with 8.51 months with taxane chemotherapy (HR, 0.79; 95% CI, 0.64-0.97), reported Keisho Chin, of The Cancer Institute Hospital of JFCR, Japan, and colleagues at the 2021 Gastrointestinal Cancers Symposium.

The study included 419 patients with unresectable advanced, recurrent/refractory disease, or disease intolerant to 1 prior fluoropyrimidine/platinum-based chemotherapy. The patients were randomly assigned to receive nivolumab (n=210) or chemotherapy (n=209).  The primary end point was OS.

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The rate of OS at 24 months was 20.2% for nivolumab and 13.5% for chemotherapy; at 36 months it was 15.3% and 8.7%, for nivolumab vs chemotherapy, respectively. 

The researchers also looked at OS by best overall response and found that nivolumab showed a longer median OS compared with chemotherapy, regardless of the best overall response. Median OS in patients who had complete or partial response were 19.91 and 15.41 months for nivolumab and chemotherapy (HR, 0.84; 95% CI, 0.46-1.54). In patients with stable disease, the median OS was 17.38 and 9.36 months for nivolumab and chemotherapy, respectively (HR, 0.45; 95% CI, 0.26-0.78).

The researchers reported no new safety signals during the 3-year study follow-up.

Disclosures: Some of the study authors disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the original study. This clinical trial was supported by Ono Pharmaceutical and Bristol-Myers Squibb.

Read more of Cancer Therapy Advisor‘s coverage of the ASCO GI 2021 meeting by visiting the conference page.


Chin K, Kato K, Cho BC, et al. Three-year follow-up of ATTRACTION-3: a phase III study of nivolumab (nivo) in patients with advanced esophageal squamous cell carcinoma (ESCC) that is refractory or intolerant to previous chemotherapy. Presented at Gastrointestinal Cancer Symposium; January 15-17, 2021. Abstract 204.