KEYNOTE-585 Fails While Matterhorn Succeeds in Gastric Cancer: What Lessons Can We Learn?
- Study type
- Other
- Study name
- KEYNOTE-585 / MATTERHORN
- Design
- Editorial (commentary) accompanying the KEYNOTE-585 trial paper in J Clin Oncol; not a new trial
- Source
- J Clin Oncol · 2025
In plain words
This article is an expert's opinion on two studies that looked at adding immunotherapy to chemotherapy before and after surgery in stomach and oesophageal cancer that can be operated on. In one study (KEYNOTE-585), immunotherapy destroyed the tumour more completely in the tissue removed at surgery, but survival without the disease coming back was not clearly better. In the other study (MATTERHORN) the result was positive, and the combination of durvalumab with FLOT chemotherapy has been put forward as the new standard treatment. Be sure to decide on the right treatment together with your own doctor.
Key results
Treatment arms and regimens
Chemotherapy alone (5-FU and cisplatin). Dose details in the full text of the paper.
Durvalumab with perioperative FLOT chemotherapy. Dose details in the full text of the paper.
Source of the regimen details: Abstract of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Patients with resectable oesophageal and gastric (oesophagogastric) cancer, as in the trials discussed in this editorial. Exact eligibility criteria are not given in the abstract of the editorial.
Endpoints
According to the abstract, KEYNOTE-585 assessed the pathological complete response rate and event-free survival, as well as overall survival. The definitions of the primary and secondary endpoints are not given in the abstract of this editorial.
Safety and side effects
The abstract of this editorial gives no information on adverse events.
Clinical significance and place in guidelines
Based on the abstract, the author considers that MATTERHORN, by adding durvalumab to perioperative FLOT, has set a new standard for the treatment of resectable oesophagogastric cancer, and that the results of KEYNOTE-585, although negative, support it. Regulatory approval status and formal clinical guideline recommendations should be checked separately.
Limitations
This is an editorial, not a primary trial report; its abstract lacks numerical data (effect sizes, confidence intervals, P values and adverse events). For details, the full text of the KEYNOTE-585 paper and the MATTERHORN report should be consulted.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.