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Mini oral session - Gastrointestinal tumours, non-colorectal

1373MO - JUPITER-06: A randomized, double-blind, phase III study of toripalimab versus placebo in combination with first-line chemotherapy for treatment naive advanced or metastatic esophageal squamous cell carcinoma (ESCC)


17 Sep 2021


Mini oral session - Gastrointestinal tumours, non-colorectal


Career Development;  Cancer Research

Tumour Site

Oesophageal Cancer;  Gastric Cancer


Rui-Hua Xu


Annals of Oncology (2021) 32 (suppl_5): S1040-S1075. 10.1016/annonc/annonc708


R. Xu1, F. Wang1, C. Cui2, J. Yao3, Y. Zhang4, G. Wang5, J. Feng6, S. Yang7, Y. Fan8, J. Shi9, X. Zhang10, L. Shen11, Y. Shu12, C. Wang13, T. Dai14, T. Mao15, L. Chen16, Z. Guo17, B. Liu18, H. Pan19

Author affiliations

  • 1 Medical Oncology, Sun Yat-sen University Cancer Center, 510060 - Guangzhou/CN
  • 2 Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing/CN
  • 3 Medical Oncology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang/CN
  • 4 Gastroenterology, Harbin Medical University Cancer Hospital, Harbin/CN
  • 5 Medical Oncology, Army Medical Center of PLA, Chongqing/CN
  • 6 Medical Oncology Department, Jiangsu Cancer Hospital, 210009 - Nanjing/CN
  • 7 Department Of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, 450003 - Zhengzhou/CN
  • 8 Department Of Medical Oncology, Zhejiang Cancer Hospital, 310022 - Hangzhou/CN
  • 9 Medical Oncology, Linyi Cancer Hospital, Linyi/CN
  • 10 Medical Oncology, The Northern Jiangsu People's Hospital, Yangzhou/CN
  • 11 Key Laboratory Of Carcinogenesis And Translational Research (ministry Of Education), Peking University Cancer Hospital and Institute, Beijing/CN
  • 12 Cancer Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 210029 - Nanjing/CN
  • 13 Medical Oncology, Zhongda Hospital Southeast University, Nanjing/CN
  • 14 Medical Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou/CN
  • 15 Medical Oncology, Shanghai Chest Hospital, Shanghai/CN
  • 16 Medical Oncology, Guangxi Medical University Affiliated Tumor Hospital, Nanning/CN
  • 17 Medical Oncology, Fujian Cancer Hospital, Fuzhou/CN
  • 18 Medical Oncology, Shandong Cancer Hospital, Jinan/CN
  • 19 Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, 310016 - Hangzhou/CN


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Abstract 1373MO


Platinum-based chemotherapy is the standard first-line treatment for advanced or metastatic ESCC. Toripalimab, a humanized monoclonal antibody against PD-1, showed promising efficacy results as first-line treatment for ESCC in combination with paclitaxel plus cisplatin (TP) in a phase Ib trial. Here, we report the results of JUPITER-06 (NCT03829969), a randomized, double-blind phase III trial of toripalimab in combination with TP for advanced or metastatic ESCC.


Patients with treatment-naïve, advanced or metastatic ESCC were randomized (1:1) to receive 240 mg toripalimab or placebo in combination with TP Q3W up to 6 cycles, followed by toripalimab or placebo maintenance. Stratification factors were ECOG performance score and prior radiotherapy. The primary endpoints were progression-free survival (PFS) by a blinded independent central review (BICR) per RECIST v1.1 and overall survival (OS).


A total of 514 ESCC patients were randomized; 257 in each arm. At a prespecified interim analysis on March 22, 2021, with median follow-up of 7.4 and 7.3 months in the two arms, there was a significant improvement in OS for toripalimab over placebo (HR=0.58 [95% CI: 0.43-0.78], P=0.00037) with median OS of 17.0 vs. 11.0 months. One-year OS rates were 66.0% vs. 43.7%. A significant improvement in PFS by BICR was also detected for toripalimab over placebo (HR=0.58 [95% CI: 0.46-0.74], P<0.00001). The OS and PFS benefits were observed across key subgroups, including all PD-L1 expression subgroups. The incidence of Grade ≥3 adverse events (AEs) (73.2% vs 70.0%) and fatal AEs (8.2% vs 8.2%) were similar between the two arms; however, AEs leading to discontinuation of toripalimab/placebo (11.7% vs 6.2%); immune-related AEs (irAEs) (37.0% vs. 26.5%) and Grade ≥3 irAEs (6.6% vs. 1.6%) were more frequent in the toripalimab arm.


The addition of toripalimab to standard first-line chemotherapy in patients with ESCC showed superior PFS and OS over chemotherapy alone with a manageable safety profile. These results support the use of toripalimab with TP chemotherapy as a new first-line treatment for advanced or metastatic ESCC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Shanghai Junshi Biosciences and Coherus Biosciences.


Shanghai Junshi Biosciences and Coherus Biosciences.


R. Xu: Financial Interests, Personal, Advisory Role: Bristol-Myers Squibb; Financial Interests, Personal, Advisory Role: Merk Serono; Financial Interests, Personal, Advisory Role: Roche; Financial Interests, Personal, Advisory Role: Astellas; Financial Interests, Personal, Advisory Role: AstraZeneca. All other authors have declared no conflicts of interest.

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