MATTERHORN: FLOT plus durvalumab leads to high pCR rate in gastric cancer

Peri-operative durvalumab plus a regimen of 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) resulted in a significantly higher pathological complete response (pCR) rate than FLOT alone among patients with resectable gastric and gastro-oesophageal junction cancer.

The global, double-blind, placebo-controlled, phase 3 MATTERHORN trial (NCT04592913) randomised 948 participants with resectable gastric and gastro-oesophageal junction cancer to peri-operative FLOT or FLOT plus durvalumab. The primary endpoint of the study was event-free survival (EFS). Dr Yelena Janjigian (Memorial Sloan Kettering Cancer Center, NY, USA) shared findings of the key secondary endpoint of pCR [1].

pCR was significantly improved in participants receiving durvalumab compared with those who did not receive this additional agent (19% vs 7%; OR 3.08; 95% CI 2.03–4.67; P<0.00001). Combined complete and near-complete pathologic response rates showed a similar benefit of the durvalumab group (27% vs 14%; OR 2.19; 95% CI 1.58–3.04; P<0.00001). “The results were consistent in microsatellite instability (MSI)-high and non-MSI-high participants as well as in the subgroup of Asian patients,” added Dr Janjigian.

The MATTERHORN study showed that durvalumab, added to peri-operative FLOT, delivers a pCR benefit for patients with resectable gastric and gastro-oesophageal junction cancer. The study is ongoing for the primary endpoint of EFS.

1. Janjigian YY, et al. Pathological complete response to 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) with or without durvalumab in resectable gastric and gastroesophageal junction cancer: subgroup analysis by region from the phase 3, randomized, double-blind MATTERHORN study. LBA246, ASCO Gastrointestinal Cancers Symposium 2024, 18–20 January, San Francisco, CA, USA.

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Posted on 13 February 202417 May 2024