PMID- 37304303
OWN - NLM
STAT- MEDLINE
DCOM- 20230613
LR  - 20230614
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 14
DP  - 2023
TI  - PD-1 inhibitors-based second-line therapy for metastatic gastric cancer.
PG  - 1136437
LID - 10.3389/fimmu.2023.1136437 [doi]
LID - 1136437
AB  - BACKGROUND: Metastatic gastric cancer (MGC) patients with progression on 
      first-line treatment still have poor outcomes on chemotherapy. The KEYNOTE-061 
      study demonstrated that pembrolizumab, a PD-1inhibitor, was not better than 
      paclitaxel as second-line therapy for MGC. Herein, we explored the efficacy and 
      safety of PD-1inhibitor based treatment for MGC patients in the second line. 
      METHODS: In this observational, retrospective study, we enrolled MGC patients 
      treated with anti-PD-1 based therapy as second-line in our hospital. We primarily 
      assessed the treatment's efficacy and safety. We also evaluated the relationship 
      between clinical features and outcomes using univariate and multivariate 
      analyses. RESULTS: We enrolled 129 patients with an objective response rate (ORR) 
      of 16.3% and a disease control rate (DCR) of 79.1%. Patients treated with 
      PD-1inhibitor combined with chemotherapy and anti-angiogenic agents had ORR of 
      19.6% and higher DCR of 94.1%. The median progression-free survival (PFS) was 
      4.10 months, and the median overall survival (OS) was 7.60 months. In univariate 
      analysis, patients treated with PD-1inhibitor combined with chemotherapy and 
      anti-angiogenic agents and with prior anti-PD-1 history were significantly 
      associated with favorable PFS and OS. In the multivariate analysis, different 
      combination therapy and prior anti-PD-1 history were independent prognosis 
      biomarkers for PFS and OS. Grade 3 or 4 treatment-related adverse events (TRAEs) 
      occurred in 28 (21.7%) patients. Common adverse events (AEs) included fatigue, 
      hyper/hypothyroidism, neutrophil decrease, anemia, skin reactions, proteinuria, 
      and hypertension. We did not observe treatment-related deaths. CONCLUSION: Our 
      current results indicated that PD-1-inhibitor and chemo-anti-angiogenic agents 
      combination therapy and prior PD-1 treatment history might improve clinical 
      activity for GC immunotherapy as second-line treatment with acceptable safety 
      profiles. Further studies are needed to verify those outcomes for MGC in other 
      centers.
CI  - Copyright (c) 2023 Gou, Zhang, Wang and Dai.
FAU - Gou, Miaomiao
AU  - Gou M
AD  - Medical Oncology Department, The Fifth Medical Center, Chinese People's 
      Liberation Army General Hospital, Beijing, China.
FAU - Zhang, Yong
AU  - Zhang Y
AD  - Medical Oncology Department, The Second Medical Center, Chinese People's 
      Liberation Army General Hospital, Beijing, China.
FAU - Wang, Zhikuan
AU  - Wang Z
AD  - Medical Oncology Department, The Fifth Medical Center, Chinese People's 
      Liberation Army General Hospital, Beijing, China.
FAU - Dai, Guanghai
AU  - Dai G
AD  - Medical Oncology Department, The Fifth Medical Center, Chinese People's 
      Liberation Army General Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230522
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (Angiogenesis Inhibitors)
SB  - IM
MH  - Humans
MH  - *Immune Checkpoint Inhibitors/adverse effects
MH  - Retrospective Studies
MH  - *Stomach Neoplasms/drug therapy
MH  - Combined Modality Therapy
MH  - Immunotherapy
MH  - Angiogenesis Inhibitors
PMC - PMC10251434
OTO - NOTNLM
OT  - PD-1 inhibitors
OT  - angiogenesis
OT  - immunotherapy
OT  - metastatic gastric cancer
OT  - second-line therapy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/06/12 06:42
MHDA- 2023/06/13 06:42
PMCR- 2023/01/01
CRDT- 2023/06/12 04:07
PHST- 2023/01/04 00:00 [received]
PHST- 2023/05/05 00:00 [accepted]
PHST- 2023/06/13 06:42 [medline]
PHST- 2023/06/12 06:42 [pubmed]
PHST- 2023/06/12 04:07 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2023.1136437 [doi]
PST - epublish
SO  - Front Immunol. 2023 May 22;14:1136437. doi: 10.3389/fimmu.2023.1136437. 
      eCollection 2023.