Cancers & treatments·Regimen libraryFirst line

Nivolumab + FOLFOX or CAPOX

Checked 2026-09-09

Unresectable or metastatic HER2-negative gastric, junctional or oesophageal adenocarcinoma, first line (benefit concentrated in PD-L1 CPS 5 or above)

One cycle

every 14 days

14-day cycle, until progression; nivolumab up to 2 yearsIntravenous Continuous infusion

Components

Drug	Dose	Route	Days	Note
Nivolumab Monoclonal antibody (anti-PD-1)	240 mg (with FOLFOX) or 360 mg every 3 weeks with CAPOX	IV	D1
Oxaliplatin Third-generation platinum (DACH-platinum)	85 mg/m²	IV	D1
Leucovorin (folinic acid)	400 mg/m²	IV	D1	2-hour infusion before fluorouracil
Fluorouracil bolus Fluoropyrimidine antimetabolite	400 mg/m²	IV	D1
Fluorouracil infusion Fluoropyrimidine antimetabolite	2,400 mg/m²	IV	D1, 2 (46 h infusion)

Cycles

until progression; nivolumab up to 2 years

14-day cycle

Emetogenicity

Moderate (30-90%)

G-CSF

Not routine

Used in

Gastric & gastro-oesophageal junction cancer Oesophageal cancer

Trials

CheckMate 649

Products

NivolumabOxaliplatinFluorouracil (5-FU)

Source

CheckMate 649, Lancet 2021

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.