Adjuvant nivolumab in resected oesophageal or gastroesophageal junction cancer following neoadjuvant chemoradiotherapy : Slovenian real-world data

english

2026

volume 60, issue 2

adjuvant immunotherapy   gastroesophageal junction cancer   oesophageal cancer

Društvo radiologije in onkologije
(Obvezni izvod spletne publikacije)

Adjuvant nivolumab has become the new standard of care for patients with oesophageal and gastroesophageal junction cancer (OEC/GEJC) following neoadjuvant chemoradiotherapy (neoCRT) and surgical resection. In Slovenia, this treatment has been in use since January 2022. Here, we report the first Slovenian real-world experience with adjuvant nivolumab. Patients and methods. We conducted a retrospective, observational cohort study of patients with OEC/GEJC who received adjuvant nivolumab after neoCRT and radical resection between January 2022 and December 2023. Data on patient characteristics, treatment completion, disease progression, and immune-related adverse events (irAEs) were collected from medical records and analysed via descriptive statistics. Results. A total of 17 patients were included. The median follow-up was 34.6 months (range 11.2–55.7). The cohort included 14 (82%) males, with a mean age of 59 years. The Eastern Cooperative Oncology Group (ECOG) performance status was 0 for 15 (88%) patients and 1 for 2 (12%) patients. The tumor location was the esophagus in 9 (53%) patients and the gastroesophageal junction in 8 (47%) patients. At diagnosis, 13 (76%) patients were stage III (8th TNM classification). Histology revealed adenocarcinoma (AC) in 12 (71%) patients and squamous cell carcinoma (SCC) in 5 (29%) patients. Only 6 (35%) patients completed one year of adjuvant nivolumab. Treatment was discontinued in 5 (29%) patients due to disease progression and in 6 (35%) patients due to irAEs. Overall, 11 (65%) patients experienced irAEs of any grade. Grade 3 or 4 irAEs occurred in 4 (24%) patients: myocarditis G4 in 1 (6%) patient and colitis G3 in 3 (18%) patients. No irAE-related deaths were reported. The median disease-free survival (DFS) was 21.4 months (95% confidence interval CI, 14.6–28.9). Conclusions. Real-world data from Slovenia indicate that 65% of patients discontinued adjuvant nivolumab prematurely due to disease progression or irAEs. These findings highlight the need for careful patient selection and monitoring when using adjuvant immunotherapy in this population.

11.09.2026