FDA challenges broad use of PD-1 inhibitors in stomach cancer patients

The FDA is reassessing the approval of immune checkpoint inhibitors for treating advanced HER2-negative gastric adenocarcinoma, questioning their broad application regardless of patients’ PD-L1 expression levels. 

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The agency will convene the Oncologic Drugs Advisory Committee Sept. 26 to evaluate the risk-benefit profile of combining ICIs like nivolumab and pembrolizumab with chemotherapy as first-line treatments, according to an FDA briefing. 

Current approvals do not require PD-L1 testing, but emerging data suggests that PD-L1 expression may be a predictive biomarker for treatment efficacy. The committee will discuss whether to implement PD-L1-based patient selection criteria. 

The FDA’s review follows concerns raised by recent studies indicating limited benefits in patients with low or absent PD-L1 expression.

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