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

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