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International Journal of Clinical and Experimental Medicine Research

ISSN Online: 2575-7970 Downloads: 238042 Total View: 2613360
Frequency: quarterly ISSN Print: 2575-7989 CODEN: IJCEMH
Email: ijcemr@hillpublisher.com
Article Open Access http://dx.doi.org/10.26855/ijcemr.2022.10.021

A Meta-analysis of the Effectiveness of Combination Therapy that PD-1/PD-L1 Inhibitor Combined with Chemotherapy in Advanced Gastric Carcinoma

Sakarie Mustafe Hidig1,*, Chao Li2

1Department of Gastrointestinal Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China.

2Department of General Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China.

*Corresponding author: Sakarie Mustafe Hidig

Published: November 17,2022

Abstract

Objective: Gastric cancer (GC) is one of the most important upper gastrointestinal malignancies worldwide. Anti-tumor effect of PD-1/PD-L1 inhibitor alone is insufficient, furthermore its combination chemotherapy provides a new direction. To analyze the effectiveness and safety of combination therapy of PD-1/PD-L1 inhibitor combined with CHEMO in regimens of advanced gastric carcinoma (GC). Chinese and English databases were searched to collect clinical randomized controlled trials (RCTs) of PD-1/PD-L1 inhibitors combined with CHEMO in therapy of advanced carcinoma GC/ gastroesophageal junction cancer (GEJC). Combined group ORR (OR=2.63, 95%CI: 1.47~4.68) and DCR (OR=2.42, 95%CI: 1.07~5.51) higher than the control group, FPS (HR=0.71, 95%CI: 0.65~0.77) and OS (HR=0.80, 95%CI: 0.73~0.86) showed a significantly better condition than control group. The occurrence rate of grade 3-5 untoward effects in the combination group showed a higher data than control group, OR=1.24 (95CI: 1.03, 1.49). PD-1/PD-L1 inhibitor combined with CHEMO can promote the treatment effect in advanced GC and build up the medical forecast of patients, but it can increase the incidence of serious adverse reactions.

References

[1] Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 71(3), 209-249.

[2] Feng, F., Liu, J., Wang, F., Zheng, G., Wang, Q., Liu, S., ... & Zhang, H. (2018). Prognostic value of differentiation status in gastric cancer. BMC cancer, 18(1), 1-6.

[3] Xing, X., Guo, J., Ding, G., Li, B., Dong, B., Feng, Q., ... & Ji, J. (2018). Analysis of PD1, PDL1, PDL2 expression and T cells infiltration in 1014 gastric cancer patients. Oncoimmunology, 7(3), e1356144.

[4] Kang, Y. K., Boku, N., Satoh, T., Ryu, M. H., Chao, Y., Kato, K., ... & Chen, L. T. (2017). Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet, 390(10111), 2461-2471.

[5] Iwasa, S., Muro, K., Satoh, T., Hironaka, S., Esaki, T., Nishina, T., ... & Watanabe, M. (2019). Phase 1 trial of avelumab (an-ti-PD-L1) in Japanese patients with advanced solid tumors, including dose expansion in patients with gastric or gastroesophageal junction cancer: the JAVELIN Solid Tumor JPN trial. Gastric Cancer, 22(4), 817-827.

[6] Bang, Y. J., Kang, Y. K., Catenacci, D. V., Muro, K., Fuchs, C. S., Geva, R., ... & Chung, H. C. (2019). Pembrolizumab alone or in combination with chemotherapy as first-line therapy for patients with advanced gastric or gastroesophageal junction adenocarcinoma: results from the phase II nonrandomized KEYNOTE-059 study. Gastric Cancer, 22(4), 828-837.

[7] Alsina, M., Moehler, M., Hierro, C., Guardeño, R., & Tabernero, J. (2016). Immunotherapy for gastric cancer: a focus on immune checkpoints. Targeted oncology, 11(4), 469-477.

[8] Muro, K., Chung, H. C., Shankaran, V., Geva, R., Catenacci, D., Gupta, S., ... & Bang, Y. J. (2016). Pembrolizumab for patients with PD-L1-positive advanced gastric cancer (KEYNOTE-012): a multicentre, open-label, phase 1b trial. The lancet oncology, 17(6), 717-726.

[9] Shitara, K., Özgüroğlu, M., Bang, Y. J., Di Bartolomeo, M., Mandalà, M., Ryu, M. H., ... & Becerra, C. (2018). Pembrolizumab versus paclitaxel for previously treated, advanced gastric or gastro-oesophageal junction cancer (KEYNOTE-061): a randomised, open-label, controlled, phase 3 trial. The Lancet, 392(10142), 123-133.

[10] Chen, L. T., Satoh, T., Ryu, M. H., Chao, Y., Kato, K., Chung, H. C., ... & Boku, N. (2020). A phase 3 study of nivolumab in previously treated advanced gastric or gastroesophageal junction cancer (ATTRACTION-2): 2-year update data. Gastric Cancer, 23(3), 510-519.

[11] Chung, H. C., Ros, W., Delord, J. P., Perets, R., Italiano, A., Shapira-Frommer, R., ... & Leary, A. (2019). Efficacy and safety of pembrolizumab in previously treated advanced cervical cancer: results from the phase II KEYNOTE-158 study. Journal of Clinical Oncology, 37(17).

[12] Eigentler, T. K., Hassel, J. C., Berking, C., Aberle, J., Bachmann, O., Grünwald, V., ... & Gutzmer, R. (2016). Diagnosis, monitoring and management of immune-related adverse drug reactions of anti-PD-1 antibody therapy. Cancer treatment reviews, 45, 7-18.

[13] Wang, M., Ma, X., Guo, L., & Xia, F. (2017). Safety and efficacy profile of pembrolizumab in solid cancer: pooled reanalysis based on randomized controlled trials. Drug design, development and therapy, 11, 2851.

How to cite this paper

A Meta-analysis of the Effectiveness of Combination Therapy that PD-1/PD-L1 Inhibitor Combined with Chemotherapy in Advanced Gastric Carcinoma

How to cite this paper: Sakarie Mustafe Hidig, Chao Li. (2022) A Meta-analysis of the Effectiveness of Combination Therapy that PD-1/PD-L1 Inhibitor Combined with Chemotherapy in Advanced Gastric Carcinoma. International Journal of Clinical and Experimental Medicine Research6(4), 446-454.

DOI: http://dx.doi.org/10.26855/ijcemr.2022.10.021