The role of immune checkpoint inhibitors in the treatment sequence of advanced gastric or gastro-esophageal junction cancer: A systematic review and meta-analysis of randomized trials. (May 2022)

• Record Type: Journal Article
• Authors: Dubois, Marco; Liscia, Nicole; Brunetti, Oronzo; Ziranu, Pina; Lai, Eleonora; Argentiero, Antonella; Mazza, Elena; Cascinu, Stefano; Silvestris, Nicola; Casadei-Gardini, Andrea; Scartozzi, Mario
• Is Part Of: Critical reviews in oncology/hematology. Volume 173(2022)
• Publication Date: 2022-05
• Subjects: Immunotherapy -- Immune checkpoint inhibitors -- Chemotherapy -- Advanced gastric cancer -- Gastroesophageal-junction cancer -- Immune checkpoint inhibitors chemotherapy association; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2022.103674
• Languages: English
• ISSNs: 1040-8428

Abstract

Abstract: Purpose: This study aimed to clarify the current knowledge on the use of immunotherapy in patients with advanced gastric(G)/gastroesophageal(GEJ) cancers. Materials and methods: A meta-analysis was done to evaluate the efficacy of immune checkpoint inhibitors(ICIs) in G/GEJ cancer both in the unselected population and in that stratified for combined positive score (CPS)≥ 1 and ≥ 10 patients. Results: In the unselected population the result showed 21%(P < 0.00001), and 29%(P < 0.00001) reduction of death and progression risk for patients treated with ICIs compared without ICIs, while in CPS≥ 1 and≥ 10 populations, the result showed a death reduction of 19%(P = 0.001) and 33%(P < 0.00001) respectively, and, and 23% (P < 0.00001) and 43% (P < 0.00001) progression risk reduction respectively, for patients treated with and without ICIs. Conclusion: overall survival(OS) and progression free survival(PFS) data obtained in our meta-analysis, are in favor to use ICIs in association with standard first line chemotherapy for G/GEJ cancer patients regardless to CPS status Highlights: Advanced gastric (aG) and gastroesophageal junction (GEJ) cancers remain a poor prognosis disease. Immune checkpoint inhibitors (ICIs) in first line could represent an attractive strategy for aG and GEJ cancer. It's necessary to find a combined positive score range to select patients that could benefit from ICIs.