Dr. Maron on Sequencing Considerations in the Frontline Treatment of GI Cancers

Steven Maron, MD, MSc, medical oncologist, Gastrointestinal Malignancies, Esophageal and Gastric Cancers, Targeted Therapies, Memorial Sloan Kettering Cancer Center, discusses sequencing considerations in the frontline treatment of gastrointestinal (GI) cancers.

Two retrospective publications from Japan and Minnesota, respectively, examined the sequencing oframucirumab (Cyramza)-based therapy following immunotherapy with a PD-1 inhibitor, Maron says. These studies found a dramatic increase in response rates in these patients, Maron adds. However, the durability of these responses is unknown, and this sequencing of treatments has yet to demonstrate a benefit in progression-free survival or overall survival, Maron explains.

However, the response benefit alone lends credence to the idea of using ramucirumab in the second line after first-line PD-1 inhibition, Maron continues. Additionally, there are concerns about patients who are PD-L1–low or PD-L1–negative not benefiting from first-line PD-1 inhibition, adding more questions to the sequencing options for these patients, Maron concludes.