![]() Within Europe, the incidence estimate is 81,600 cases in men and 51,500 in women. Globally, stomach cancer is the third most common cause of death from cancer. In contrast to the low incidence of oesophageal cancer, stomach cancer ranks sixth place among common cancer cases worldwide (incidence ~1,033,000 cases), resulting in approximately 780,000 deaths. Histological differentiation is relevant for individual therapy as both subgroups represent a separate disease with separate molecular patterns and risk factors. In Europe, broad regional differences exist in incidental rates dependent on the histological subtype with increasing EAC cases in most countries, while ESCC trends decrease or stabilize. Worldwide, approximately 90% of all oesophageal cancer cases account for oesophageal squamous cell carcinoma (ESCC) and 10% for oesophageal adenocarcinoma (EAC), respectively. There is a consistent decline in the mortality rates of oesophageal cancer mortality in men (from 4.5 in 2015 to 3.2/100,000), whereas the mortality rates of women stay stable (from 1.1 in 2015 to 1.2/100,000). In Europe, the incidence accounts for 53,000 new cases (40,700 men vs. About 509,000 deaths were estimated globally in 2018. Oesophageal cancer causes around 572,000 new cases globally and ranks 9th out of the 10 most common new cancer cases worldwide. We discuss the recent results of the completed phase II and III clinical trials. In third-line treatment, nivolumab shows benefits in OS regardless of PD-L1 expression (ATTRACTION-02) with approval in Asia, and pembrolizumab prolonged the duration of response in PD-L1 positive pts (KEYNOTE-059) with approval in the USA. Additionally, pembrolizumab was non-inferior to chemotherapy for OS in PD-L1 CPS ≥ 1 pts (KEYNOTE-062). ![]() In gastro-oesophageal junction and gastric cancer, the addition of nivolumab to chemotherapy in first-line treatment improves OS in pts with advanced disease with PD-L1 CPS ≥ 5 (CHECKMATE-649). These data resulted in the approval of nivolumab for the second-line treatment of advanced ESCC pts regardless of PD-L1 (programmed cell death ligand 1) status in Europe, Asia, and the USA, and pembrolizumab for pts with PD-L1 CPS (combined positivity score) ≥ 10 in Asia and the USA. In the second-line setting, nivolumab (ATTRACTION-03) and pembrolizumab (KEYNOTE-181) demonstrate a benefit in OS compared with chemotherapy. ![]() In first-line treatment, ESCC patients (pts) benefit in overall survival (OS) from the PD-1-inhibitor pembrolizumab in combination with chemotherapy (KEYNOTE-590). With regard to oesophageal squamous cell carcinoma (ESCC), the selective PD-1 (programmed cell death receptor 1)-inhibitor nivolumab improves disease-free survival in the adjuvant therapy setting (CHECKMATE-577). Immune checkpoint inhibitors enrich the therapeutic landscape in oesophago-gastric carcinoma. ![]()
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