Immune boosting antibody trialled in oesophageal cancer

A clinical trial for patients with advanced oesophageal cancer has opened in Southampton.

ELEVATE is testing an immunotherapy drug in combination with chemotherapy.

The study is led by the CRUK Southampton Clinical Trials Unit (SCTU) and Cambridge University Hospitals NHS Foundation Trust. It is supported by the NIHR Southampton Clinical Research Facility.

Treating advanced cancer

Oesophageal (OG) cancer develops in the oesophagus, sometimes called the gullet or food pipe.

ELEVATE is working with patients who have advanced oesophagogastric (OG) cancer that cannot be removed by surgery and has stopped responding to other treatments. They will be given the immunotherapy drug nivolumab, alongside the chemotherapy temozolomide.

Nivolumab is a monoclonal antibody treatment. This helps to boost the body’s own immune system by activating cells called T cells to better attack the cancer. It is already used to treat some other cancers, such as melanoma, lung cancer, and head and neck cancers.

Increasing effectiveness of treatment

Nivolumab has also been used to treat certain types of OG cancers that have not responded to previous treatment. However only around one in eight of these patients will see a response.

Researchers know that these immunotherapy treatments work better in patients who have lots of mutations in the DNA of their cancer cells. They believe increasing the number of mutations might increase the chances of response to nivolumab.

Around a third of people with OG cancer have low levels of a protein called MGMT, which helps to repair damaged DNA. It’s thought a chemotherapy drug called temozolomide may lead to more mutations to occur in the cancer cells of these patients.

Treating patients with temozolomide before giving them nivolumab could increase the effectiveness of the treatment.

Immunotherapy future

The study could pave the way to a larger trial to develop the treatment further and test nivolumab in a larger cohort of patients.

Kelly Cozens, Senior Trial Manager for ELEVATE at SCTU, said:

“Improving outcomes for oesophageal cancer patients by finding effective new treatments is a priority area for the Southampton Clinical Trials Unit. We have vast experience in designing and running trials of immunotherapy treatments, and trials for OG patients.

“We hope that the ELEVATE trial can help increase our understanding of how we can make immunotherapy a viable option for more OG patients in the future.”

ELEVATE is being funded by Bristol Myers Squibb who make nivolumab.