Background: immune checkpoint inhibitors(ICIs) have shown contradictory results in patients with advanced gastro-oesophageal junction/gastric cancer(GOJ/GC).Aim: to identify specific patient subgroups that would derive survival benefit from ICIs.Methods: a subgroup meta-analysis of randomised clinical trials(RCTs) was carried out.Results: four phase-III-RCTs were identified with data on the following variables: primary location(Gastric vs GOJ); age(<= 65 vs 65); gender(male vs female); ECOG PS(0 vs 1); ethnicity (Asian vs non-Asian), histology (intestinal vs diffuse), PD-L1 expression(>= 1% vs < 1%). PD-L1 positivity was significantly associated with survival benefit from ICIs (HR: 0.82, p 0.047), with a significant interaction between PD-L1 expression and ICI efficacy (interaction HR: 1.41, p 0.02). Numerically, the second most relevant interaction was ICI efficacy and gender, with ICI being more effective in males.Conclusion: The PD-L1 positive patient subgroup derives significant survival benefit from ICI in GOJ/GC, how ever other predictors are eagerly needed to further refine patient selection.
Formica, V., Morelli, C., Patrikidou, A., Shiu, K.k., Nardecchia, A., Lucchetti, J., et al. (2021). A systematic review and meta-analysis of PD-1/PD-L1 inhibitors in specific patient subgroups with advanced gastro-oesophageal junction and gastric adenocarcinoma. CRITICAL REVIEWS IN ONCOLOGY/HEMATOLOGY, 157, 103173 [10.1016/j.critrevonc.2020.103173].
A systematic review and meta-analysis of PD-1/PD-L1 inhibitors in specific patient subgroups with advanced gastro-oesophageal junction and gastric adenocarcinoma
Formica, V
;Roselli, M;
2021-01-01
Abstract
Background: immune checkpoint inhibitors(ICIs) have shown contradictory results in patients with advanced gastro-oesophageal junction/gastric cancer(GOJ/GC).Aim: to identify specific patient subgroups that would derive survival benefit from ICIs.Methods: a subgroup meta-analysis of randomised clinical trials(RCTs) was carried out.Results: four phase-III-RCTs were identified with data on the following variables: primary location(Gastric vs GOJ); age(<= 65 vs 65); gender(male vs female); ECOG PS(0 vs 1); ethnicity (Asian vs non-Asian), histology (intestinal vs diffuse), PD-L1 expression(>= 1% vs < 1%). PD-L1 positivity was significantly associated with survival benefit from ICIs (HR: 0.82, p 0.047), with a significant interaction between PD-L1 expression and ICI efficacy (interaction HR: 1.41, p 0.02). Numerically, the second most relevant interaction was ICI efficacy and gender, with ICI being more effective in males.Conclusion: The PD-L1 positive patient subgroup derives significant survival benefit from ICI in GOJ/GC, how ever other predictors are eagerly needed to further refine patient selection.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
