Evidence map›Paper›PMID 39002179›Full record

Trial reportESMO open2024

Maintenance durvalumab after first-line chemotherapy in patients with HER2-negative advanced oesophago-gastric adenocarcinoma: results from the randomised PLATFORM study.

C Fong, B Patel, C Peckitt, E Bourmpaki, L Satchwell, S Cromarty, S Kidd, K von Loga, M Uhlik, R Begum and 17 more

Abstract readRandomized Controlled TrialClinical Trial, Phase IIAdaptive Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in ESMO open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

C FongGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
B PatelGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
C PeckittResearch Data & Statistics Unit, Royal Marsden Clinical Trials Unit, Royal Marsden Hospital, London and Surrey.
E BourmpakiResearch Data & Statistics Unit, Royal Marsden Clinical Trials Unit, Royal Marsden Hospital, London and Surrey.
L SatchwellResearch Data & Statistics Unit, Royal Marsden Clinical Trials Unit, Royal Marsden Hospital, London and Surrey.
S CromartyGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
S KiddGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
K von LogaIntegrative Pathology Unit, Institute of Cancer Research, Sutton, UK.
M UhlikResearch and Biomarker Discovery, OncXerna Therapeutics, Inc., Waltham, USA.
R BegumGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
T RanaGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
T WaddellDepartment of Medical Oncology, The Christie NHS Foundation Trust, Manchester.
S DarbyWeston Park Cancer Centre, Sheffield.
A BradshawCancer Services, The Freeman Hospital's Northern Centre for Cancer Care, Newcastle.
T RoquesDepartment of Clinical Oncology, Norfolk and Norwich University Hospital, Norfolk & Norwich.
C MorganDepartment of Clinical Oncology, Velindre Cancer Centre, Cardiff.
C ReesCancer Care Division, Medical Oncology Department, University Hospital Southampton NHS Foundation Trust, Southampton.
R HerbertsonSussex Cancer Centre, Royal Sussex County Hospital, Brighton.
P DasDepartment of Oncology, University Hospitals of Derby and University of Nottingham School of Medicine.
C ThompsonUniversity Hospitals of Morecambe Bay NHS Foundation Trust, Kendal.
M HewishRoyal Surrey Cancer Centre, Royal Surrey Hospitals NHS Foundation Trust, Guildford.
R PettyDivision of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee.
F ThistlethwaiteDepartment of Medical Oncology, The Christie NHS Foundation Trust and Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK.
S RaoGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
N StarlingGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
I ChauGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey.
D CunninghamGastrointestinal Unit, Department of Medicine, Royal Marsden Hospital, London and Surrey. Electronic address: david.cunningahm@rmh.nhs.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPLAnning Treatment For Oesophago-gastric Cancer: a Randomised Maintenance Therapy Trial (PLATFORM) is an adaptive phase II study assessing the role of maintenance therapies in advanced oesophago-gastric (OG) adenocarcinoma. We evaluated the role of the anti-programmed death-ligand 1 (PD-L1) inhibitor durvalumab in these patients. PATIENTS AND

methodsPatients with human epidermal growth factor receptor 2-negative locally advanced or metastatic OG adenocarcinoma with disease control or response to 18 weeks of platinum-based first-line chemotherapy were randomised to active surveillance or maintenance durvalumab. The primary endpoint was progression-free survival (PFS). Safety was assessed in all patients who had commenced surveillance visits or received at least one dose of durvalumab. Exploratory survival analyses according to PD-L1 Combined Positive Score (CPS) and immune (biomarker-positive) or angiogenesis dominant (biomarker-negative) tumour microenvironment (TME) phenotypes were conducted.

resultsBetween March 2015 and April 2020, 205 patients were randomised to surveillance (n = 100) and durvalumab (n = 105). No significant differences were seen in PFS [hazard ratio (HR) 0.84, P = 0.13] and overall survival (OS; HR 0.98, P = 0.45) between surveillance and durvalumab. Five patients randomised to durvalumab demonstrated incremental radiological responses compared with none with surveillance. Treatment-related adverse events occurred in 77 (76.2%) durvalumab-assigned patients. A favourable effect in OS with durvalumab over surveillance in CPS ≥5 and immune biomarker-positive patients was observed compared with CPS <5 and biomarker-negative subgroups, respectively: CPS ≥5 versus <5: HR 0.63, 95% confidence interval (CI) 0.32-1.22 versus HR 0.93, 95% CI 0.44-1.96; biomarker-positive versus negative: HR 0.60, 95% CI 0.29-1.23 versus HR 0.84, 95% CI 0.42-1.65.

conclusionMaintenance durvalumab does not improve PFS in patients with OG adenocarcinoma who respond to first-line chemotherapy but induced incremental radiological responses in a subset of patients. TME characterisation could refine patient selection for anti-PD-L1 therapy above PD-L1 CPS alone.

Indexed as

AdenocarcinomaAntibodies, MonoclonalEsophageal NeoplasmsStomach NeoplasmsAdultAgedAged, 80 and overAntineoplastic Agents, ImmunologicalErb-b2 Receptor Tyrosine KinasesFemaleHumansMaleMiddle AgedProgression-Free SurvivalAntibodies, MonoclonalAntineoplastic Agents, ImmunologicaldurvalumabERBB2 protein, humanErb-b2 Receptor Tyrosine Kinasescheckpoint inhibitordurvalumabgastric cancermaintenance therapyoesophageal adenocarcinoma

Identifiers

PMID39002179
PMCPMC11298822

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.