ArticleJTCVS open2025
Real-world use of adjuvant nivolumab among patients with esophageal and gastroesophageal junction cancer at a large integrated health system.
Article in JTCVS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To assess real-world use of adjuvant nivolumab in patients with esophageal/gastroesophageal junction cancer. Methods: This was a retrospective, non-interventional cohort study of electronic health record data in the Kaiser Permanente Northern California cancer registry (June 1, 2020, to October 31, 2024). Index was chemoradiation therapy date between December 1, 2020, and August 31, 2023, with 6 months baseline and ≥12 months' follow-up. Included patients were aged ≥18 years at index; had stage II/III esophageal/gastroesophageal junction cancer; were receiving chemoradiation within the index period; had evidence of local disease after neoadjuvant chemoradiation; and were classified as Eastern Cooperative Oncology Group performance score 0-1 at index. Patient demographic and clinical characteristics, as well as clinical and patient journey outcomes, were extracted from electronic medical records, confirmed by chart review. Descriptive statistics describe outcomes with Kaplan-Meier method used for time-to-event outcomes. Results: Included patients (n = 44; median age 66.0 years; interquartile range, 61.5-73.0 years) were followed for median 19.1 months (interquartile range, 10.6-25.3 months) from nivolumab first dose. Median overall survival was not reached. The 24-month overall survival rate was 72.3% (95% confidence interval, 58.7%-89.1%). Median disease-free survival was 20.8 months, and median distant metastases-free survival was 23.7 months (95% confidence interval, 13.0-not reached). All patients underwent minimally invasive esophagectomy and had R0 resection status. Median time from index to nivolumab initiation was 165 days (interquartile range, 138.5-194.0 days). Median duration of nivolumab treatment was 322 days (interquartile range, 148.5-364.0 days); 52.3% of patients completed 1 year of nivolumab treatment. Conclusions: This study demonstrates survival benefits of adjuvant nivolumab in line with clinical studies.
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