OnCo
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RATIONALE-306

RATIONALE-306 is the trial behind tislelizumab's US approval for squamous oesophageal cancer, with the biggest gains in PD-L1-positive tumours.

OS 17.2 vs 10.6 months overall (HR 0.66; Lancet Oncology 2023); PD-L1 ≥1%: 16.8 vs 9.6 months. FDA approval 4 March 2025 restricted to PD-L1 ≥1% (TAP). Also approved in EU (2024).

Setting
First-line advanced oesophageal squamous cell carcinoma: tislelizumab + platinum chemotherapy vs placebo + chemotherapy
Phase
Phase 3
Sponsor
BeOne (BeiGene)
Registry
Headline result
OS 17.2 vs 10.6 months (HR 0.66); PD-L1 ≥1% OS 16.8 vs 9.6 months.
Reported
2022
Enrolled
649
Replication
Consistent with KEYNOTE-590, CheckMate 648, ESCORT-1st.

Outcomes

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In plain words
What these results mean for people, not percentages
649 people took part
Overall survival, all patientsprimarysurvival endpoint
  • Median 17.2 vs 10.6 months with Tislelizumab + chemotherapy compared with Placebo + chemotherapy; about 6.6 months longer for half the group.
  • A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
  • Put another way, the treated group had about 34 percent lower chance of the event at any given time (hazard ratio 0.66).
Overall survival, PD-L1 ≥1%survival endpoint
  • Median 16.8 vs 9.6 months with Tislelizumab + chemotherapy compared with Placebo + chemotherapy; about 7.2 months longer for half the group.
  • A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
Be careful
  • Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
  • These results apply to the people the trial enrolled: First-line advanced oesophageal squamous cell carcinoma: tislelizumab + platinum chemotherapy vs placebo + chemotherapy. People in a different situation may not see the same effect.

Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.

649 participants enrolled.

Overall survival, all patientsprimary
HR 0.66
Tislelizumab + chemotherapy
17.2 mo
Placebo + chemotherapy
10.6 mo
Source
Overall survival, PD-L1 ≥1%
Tislelizumab + chemotherapy
16.8 mo
Placebo + chemotherapy
9.6 mo
Source
EndpointArmnValueHR (95% CI)pSource
Overall survival, all patientsprimaryTislelizumab + chemotherapy32617.2 months0.66link
Placebo + chemotherapy32310.6 months
Overall survival, PD-L1 ≥1%Tislelizumab + chemotherapy16.8 monthslink
Placebo + chemotherapy9.6 months
Replication
Consistent with KEYNOTE-590, CheckMate 648, ESCORT-1st.

Connected

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