Readministration of nivolumab for patients with advanced gastric cancer: a case series

Nivolumab (NIVO), an immune checkpoint inhibitor (ICI) combined with chemotherapy, represents the standard of care for patients with human epidermal growth factor receptor 2-negative advanced gastric cancer (AGC). Although ICI readministration either as a rechallenge following disease progression or as a reintroduction after refractory has demonstrated clinical benefit and safety in patients with lung cancer or melanoma, evidence in AGC remains limited.

This case series analyzed eight patients with AGC who received NIVO readministration monotherapy between September 2017 and December 2021.

Six patients transitioned after disease progression, while two patients discontinued initial NIVO due to grade 2 pneumonitis. Among six patients with NIVO rechallenge, median progression-free survival (PFS) after rechallenge was 1.8 months [95% confidence interval (CI) 0.6-19.3 months], and median overall survival (OS) was 17.9 months (95% CI 1.8-42 months). Two patients achieved stable disease. Patients with ascites, Eastern Cooperative Oncology Group performance status of 1, or bulky liver/peritoneal metastasis tended toward shorter PFS and OS. Among two patients with NIVO reintroduction, one patient experienced a grade 2 rash; however, neither patient developed pneumonitis.

NIVO readministration may offer clinical benefit to selected patients with AGC, without inducing severe adverse events.