Tislelizumab Approval Adds to Armamentarium in Metastatic Esophageal Cancer

Commentary
Video

Patients with unresectable or metastatic esophageal squamous cell carcinoma and higher PD-L1 expression may benefit from treatment with tislelizumab, according to Syma Iqbal, MD.

The FDA approval of tislelizumab-jsgr (Tevimbra) as a treatment for patients with unresectable or metastatic esophageal squamous cell carcinoma (ESCC) following prior chemotherapy adds to the armamentarium of PD-1 inhibitors for use in the second-line setting, said Syma Iqbal, MD.

In a conversation with CancerNetwork® regarding the drug’s FDA approval, Iqbal, an associate professor of clinical medicine and the section chief of Gastrointestinal Oncology in the Division of Medical Oncology and a cancer physician in chief at Norris Comprehensive Cancer/Keck School of Medicine at the University of Southern California, spoke about how she plans to implement this agent into her clinical practice.

According to Iqbal, tislelizumab appears to especially have a benefit among patients with a higher PD-L1 expression. This finding confirms PD-L1 expression status as a marker of response that practices should look to evaluate in this population. Additionally, she said that this agent would be a suitable therapy option for those who received frontline chemotherapy for advanced disease.

Transcript:

Tislelizumab is a PD-1 inhibitor that has demonstrated activity in the second-line setting for patients with advanced or metastatic [esophageal] squamous cell carcinoma. This [approval] is adding to our armamentarium in the second-line setting, allowing for another therapeutic option.

This [approval] adds to the PD-1 inhibitors in the second-line setting for squamous cell carcinoma. It did look like those patients who had higher PD-L1 expression benefited more from the addition of the PD-1 inhibitor. Once again, we’re finding that PD-1 expression is a marker of responding to therapy, so it is something that we should be checking in our patients.

For patients with advanced disease who have received chemotherapy upfront, one could then switch to a PD-1 inhibitor in the second-line setting, and tislelizumab would serve that function. This [treatment] is for patients who have not seen prior immunotherapy.

Reference

BeiGene receives FDA approval for TEVIMBRA for the treatment of advanced or metastatic esophageal squamous cell carcinoma after prior chemotherapy. News release. BeiGene. March 14, 2024. Accessed April 4, 2024. https://shorturl.at/bzZ37

Recent Videos
Experts from Vanderbilt University Medical Center emphasize gathering a second opinion to determine if a tumor is resectable in patients with pancreatic cancer.
Experts from Vanderbilt University Medical Center discuss the use of intraoperative radiation therapy in a 64-year-old patient with pancreatic cancer.
Although no responses were observed in 11 patients receiving abemaciclib monotherapy, combination therapies with abemaciclib may offer clinical benefit.
Findings show no difference in overall survival between various treatments for metastatic RCC previously managed with immunotherapy and TKIs.
An epigenomic profiling approach may help pick up the entire tumor burden, thereby assisting with detecting sarcomatoid features in those with RCC.
Investigators are assessing the use of IORT in patients with borderline resectable or unresectable pancreatic cancer as part of the phase 2 PACER trial.
The approval for epcoritamab in patients with R/R follicular lymphoma was supported by encouraging efficacy findings from the phase 1/2 EPCORE NHL-1 trial.
A phase 1/2 trial assessed the use of menin inhibitor DSP-5336 in patients with acute leukemia overexpressing HOXA9 and MEIS1.
A phase 1 trial assessed the use of PSCA-directed CAR T cells in patients with metastatic castration-resistant prostate cancer.
A pooled analysis trial assessed the impact of acalabrutinib in patients with chronic lymphocytic leukemia across treatment lines.