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Gastrointestinal Oncology
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Nivolumab for the Treatment of Esophageal Squamous Cell Carcinoma

Published Online: December 23rd 2020 Oncology & Hematology Review (US). 2020;16(2):Online ahead of journal publication
Authors: Mao Okada, Shun Yamamoto, Ken Kato
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Article Information

Esophageal cancer is the seventh most common malignancy, for which there are few effective treatment options, especially for patients with advanced disease. Therefore, the therapeutic development of immune checkpoint inhibitors has been the focus for patients with advanced esophageal cancer. Nivolumab, a human monoclonal immunoglobulin G4 antibody that inhibits programmed cell death protein 1, has been developed for this patient population. The phase II ATTRACTION-1 trial showed promising efficacy for nivolumab in patients with advanced esophageal cancer who were refractory or intolerant to fluoropyrimidine-, platinum-, and taxane-based chemotherapies. The phase III ATTRACTION-3 trial showed the superiority of nivolumab over taxane in patients with advanced esophageal squamous cell carcinoma (ESCC) who were refractory or intolerant to previous fluoropyrimidine- and platinum-based chemotherapy. Based on these results, the FDA approved nivolumab as a treatment for patients with advanced ESCC after prior fluoropyrimidine- and platinum-based chemotherapy. Additionally, the CheckMate 577 trial has shown that nivolumab improves disease-free survival when used as an adjuvant treatment in patients with resectable tumors who received neoadjuvant chemoradiation followed by surgery, and in whom a pathological complete response was not achieved. Clinical trials to evaluate the efficacy of nivolumab in combination with cytotoxic drugs as first-line chemotherapy, in combination with chemoradiotherapy, or for the treatment of perioperative patients with esophageal cancer are ongoing and might contribute to the establishment of new standard treatments.


Esophageal adenocarcinoma, esophageal cancer, esophageal squamous cell carcinoma, immune checkpoint inhibitor, nivolumab, PD-1 antibody, pembrolizumab


**This manuscript has been accepted for publication, but not yet copyedited or typeset, and may be subject to minor changes during the production process**

Article Information:

Shun Yamamoto has received personal fees from ONO Pharmaceuticals. Ken Kato has received research funds from ONO Pharmaceuticals, MSD, Shionogi, Oncolys Biopharma, Chugai, AstraZeneca, and Beigene; and personal fees from Eli Lilly and Taiho. Mao Okada has no financial or non-financial relationships or activities to declare in relation to this article.

Compliance With Ethics

This article involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors.

Review Process

Double-blind peer review.


The named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published.


Ken Kato, Department of Head and Neck Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
E: kenkato@ncc.go.jp


No funding was received in the publication of this article.

Open Access

This article is freely accessible at touchONCOLOGY.com  © Touch Medical Media 2020.



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