Avelumab (anti–PD-L1) + modified DCF perioperative chemo delivers 61% 5-year OS in locally advanced GEA

Avelumab, a PD-L1 checkpoint inhibitor, was combined with perioperative modified DCF (docetaxel/cisplatin/5-FU) in a single-arm Phase II study in locally advanced gastro-esophageal adenocarcinoma (cT3–4 and/or N+, PS 0–1; NCT03288350). In the survival-evaluable cohort (n=50), 98% completed neoadjuvant therapy and all underwent surgery; major pathologic response (MPR; CAP TRG 0–1) occurred in 18% (9/50), with 5-year DFS 55.3% and 5-year OS 61.1% at median follow-up 71.5 months—numerically above historical perioperative chemotherapy benchmarks such as MAGIC (ECF; 5-year OS 36%) and in the range/above FLOT4 (FLOT; ~45% 5-year OS, median OS 50 months), though cross-trial comparisons are imperfect. No new safety signals were reported; notably, the MPR subgroup had 100% 5-year DFS and OS (highly hypothesis-generating given small n and potential selection/guarantee-time effects).