1L GC/GEJC icon

Proven to extend overall survival in patients with 1L GC/GEJC and PD-L1 scores ≥1%1

Key Efficacy Outcome: OS in PD-L1 ≥1%

15.0 months of median overall survival with TEVIMBRA + chemotherapy vs 12.8 months with placebo + chemotherapy

1L GC/GEJC trial OS graph
1L GC/GEJC trial OS graph

Limitation: Efficacy analysis was not powered for statistical comparison and is descriptive only. No definitive conclusions can be drawn.

NCCN Category 2A Preferred treatment option for 1L GC/GEJC
NCCN Category 2A Preferred treatment option for 1L GC/GEJC

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Expert Review of Overall Survival Data and NCCN Recommendations

Marcia Cruz-Correa, MD, PhD, AGAF, FASGE, discusses the latest NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) in 1L ESCC and 1L GC/GEJC and examines overall survival data for patients treated with tislelizumab-jsgr (TEVIMBRA®) + chemotherapy vs placebo + chemotherapy.

3-Year Exploratory Follow-Up: OS in PD-L1 ≥1%

Overall survival sustained over 3 years4

21.3% of patients were still alive at 3 years with TEVIMBRA + chemotherapy (95% CI: 17.5-25.4) vs 13.1% with placebo + chemotherapy (95% CI: 10.1-16.5)

1L GC/GEJC trial OS 3-yr follow-up graph
1L GC/GEJC trial OS 3-yr follow-up graph

Limitation: The 3-year OS analysis was exploratory in nature and was not powered to show statistical significance. Landmark OS rates were estimated using the Kaplan-Meier method. No definitive conclusions can be drawn.

Subgroup Analyses: OS in PD-L1 ≥1%

A consistent trend in overall survival favoring TEVIMBRA + chemotherapy across multiple key subgroups4

TEVIMBRA + chemotherapy reported overall survival across common sites of metastases

1l-gc-trial-os-subgroup-analysis-table-dktp@2x

Analyses of OS*

1l-gc-trial-os-subgroup-analysis-table-mobile@2x

Limitation: Post-hoc subgroup analyses were not statistically powered and were descriptive only. No definitive conclusions can be drawn.

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Expert Opinion on RATIONALE-305 OS Subgroup Analyses

Dr. Dani Castillo, MD, reviews subgroup analyses of overall survival, which included positive outcomes with TEVIMBRA + chemotherapy in patients with peritoneal metastases.8

Frequently Asked Questions

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TEVIMBRA + chemotherapy is proven to extend overall survival in patients with 1L GC/GEJC and PD-L1 scores ≥1%. TEVIMBRA + chemotherapy demonstrated 15.0 months median overall survival vs 12.8 months median overall survival with placebo + chemotherapy. The hazard ratio was 0.78 with a 95% confidence interval of 0.67-0.90.1
TEVIMBRA + chemotherapy provided sustained overall survival for 3 years. 21.3% of patients were still alive at 3 years with TEVIMBRA + chemotherapy vs 13.1% with placebo + chemotherapy. The hazard ratio was 0.77 with a 95% confidence interval of 0.67-0.90.4

Limitation: The 3-year OS analysis was exploratory in nature and was not powered to show statistical significance. Landmark OS rates were estimated using the Kaplan-Meier method. No definitive conclusions can be drawn.

In a post hoc subgroup analysis, results showed a consistent trend in overall survival favoring TEVIMBRA + chemotherapy across multiple key subgroups. TEVIMBRA + chemotherapy is the first and only immunotherapy + chemotherapy treatment with positive survival for patients with peritoneal metastases in trials using a PD-L1 score cutoff of ≥1%. TEVIMBRA + chemotherapy (n=190) reported 12.2 months median overall survival vs 11.9 months with placebo + chemotherapy (n=196) in patients with peritoneal metastases. The hazard ratio was 0.79 (95% CI: 0.64-0.98). TEVIMBRA + chemotherapy (n=242) reported 18.0 months median overall survival vs 13.7 months with placebo + chemotherapy (n=258) in patients without peritoneal metastases. The hazard ratio was 0.76 (95% CI: 0.62-0.92).5-8

Limitation: Post-hoc subgroup analyses were not statistically powered and were descriptive only. No definitive conclusions can be drawn.

The NCCN recommends tislelizumab-jsgr (TEVIMBRA®) as an NCCN Category 2A Preferred treatment option, in combination with fluoropyrimidine and oxaliplatin or cisplatin,* for adults with 1L, unresectable, locally advanced, recurrent, or metastatic, HER2-negative GC or GEJ adenocarcinoma whose tumors express PD-L1 (≥1).*To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.2,3

*Category 1 Preferred for patients whose tumors express PD-L1 (≥5).
PD-L1 expression levels as determined by CPS.

1L, first line; dMMR, deficient mismatch repair; ECOG, Eastern Cooperative Oncology Group; GC, gastric cancer; GEJ, gastroesophageal junction; GEJC, gastroesophageal junction cancer; HR, hazard ratio; MMR, mismatch repair; mOS, median overall survival; MSI, microsatellite instability; MSI-H, microsatellite instability high; MSI-L, microsatellite instability low; MSS, microsatellite stable; ORR, overall response rate; OS, overall survival; PD-L1, programmed death ligand 1; PFS, progression-free survival; pMMR, proficient mismatch repair; PS, performance status.

References: 1. TEVIMBRA. Prescribing Information. BeOne Medicines USA, Inc.; 2025. 2. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Esophageal and Esophagogastric Junction Cancers V.2.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed February 25, 2026. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 3. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Gastric Cancer V.2.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed February 25, 2026. To view the most recent and complete version of the guideline, go online to NCCN.org. 4. Moehler M, Oh DY, Kato K, et al. Adv Ther. 2025;42(5):2248-2268. 5. Rha SY, Oh DY, Yañez P, et al; KEYNOTE-859 Investigators. Lancet Oncol. 2023;24(11):1181-1195. doi:10.1016/S1470-2045(23)00515-06 Published correction appears in Lancet Oncol. 2024;25(12):e626. doi:10.1016/S1470-2045(24)00650-8 6. Janjigian YY, Ajani JA, Moehler M, et al. J Clin Oncol. 2024;42(17):2012-2020. doi:10.1200/JCO.23.01601 7. Shitara K, Moehler M, Ajani J, et al. Poster presented at: American Society of Clinical Oncology Gastrointestinal Cancers Symposium; January 18-20, 2024; San Francisco, CA. Poster Bd E6. 8. Sonbol MB, Rha SY, Xu RH, et al. Abstract and poster presented at: ASCO Gastrointestinal Cancers Symposium; January 8-10, 2026. San Francisco, CA. Abstract 378, poster D9.

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