I am a PI with the ATTRACTION-4 trial which compared chemo plus nivolumab versus chemo plus placebo as a first line treatment for advanced gastric cancer. This trial has two primary endpoints, one is PFS and the other is OS. In the protocol it was pre-specified that the objective of this study will be achieved if at least one of the two primary endpoints is met.

Over 700 patients were enrolled from Japan, Korea and Taiwan and background characteristics were well balanced between the two treatment arms. Then chemo plus nivolumab has shown a statistically significant improvement in progression free survival but not OS.

Chemo plus nivolumab also had shown a higher response rate compared to placebo plus chemo and the response duration was quite long. The toxicity was manageable.

So our conclusion is chemo plus nivolumab has a clinically meaningful improvement in the treatment of advanced gastric cancer. I hope in the near future nivolumab will be available in the first line treatment for advanced gastric cancer.

In another presentation at this ESMO meeting I reported the real-world data of nivolumab as a salvage line treatment for advanced gastric cancer. The response rate was about 10% and the toxicity profile is quite similar to the ATTRACTION-2 trial. So already in Japan nivolumab is available for the treatment of advanced gastric cancer. I believe it contributes to prolong the survival of gastric cancer patients and maintain their quality of life.

That’s all, thank you.