P-86 First-line nivolumab (NIVO) plus chemotherapy (chemo) vs chemo in patients with advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC): CheckMate 649 Chinese subgroup analysis 2-year follow-up

Shen, L.; Bai, Y.; Lin, X.; Li, W.; Wang, Jie; Zhang, X.; Pan, H.; Bai, C.; Bai, L.; Cheng, Y.; Zhang, J.; Zhong, H.; Ba, Y.; Hu, W.; Xu, R.; Guo, W.; Qin, S.; Yang, N.; Lu, J.; Chanaga, C. Amaya; Soleymani, S.; Liu, T.

doi:10.1016/j.annonc.2022.04.176

Cited by 2 publications

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“…The liver is the most prevalent target organ for hematogenous metastases of gastric cancer, and a large retrospective study showed that the incidence of liver metastases in patients with stage IV gastric cancer was up to about 40% ( 12 ). The CheckMate-649 Chinese subgroup analysis with 2-year follow-up showed that the presence of liver metastases was not associated with poor prognosis in patients with advanced gastric cancer treated with immunotherapy [median overall survival (OS) in liver metastases arm vs non-liver metastases arm:14.2 vs 14.8 months] ( 13 ). Similarly, the survival benefit of Nivolumab was observed in the ATTRACTION-2 trial (Nivolumab vs placebo) or the ATTRACTION-4 trial (Nivolumab plus chemotherapy vs placebo plus chemotherapy) regardless of liver metastases of gastric cancer ( 14 , 15 ).…”

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confidence: 99%

Prognostic characteristics and clinical response to immunotherapy targeting programmed cell death 1 for patients with advanced gastric cancer with liver metastases

Liang

Huang

et al. 2022

Front. Immunol.

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BackgroundThe specific efficacy of immunotherapy for patients with liver metastases of gastric cancer is unclear. This study set out to explore the treatment response and related prognostic factors for patients with liver metastases of gastric cancer treated with immunotherapy.Patients and methodsThis retrospective cohort study included 135 patients with unresectable advanced gastric cancer. According to the presence of liver metastases and/or first-line treatment with immunotherapy, patients were divided into the following three groups: I-LM(-) group(patients without liver metastases treated with immunotherapy, n=66), I-LM(+) group(patients with liver metastases treated with immunotherapy, n=36), C-LM(+) group(patients with liver metastases treated with chemotherapy and/or target therapy, n=33). Cox regression analyses were used to identify factors associated with survival in all patients and the three groups, respectively.ResultsFor the patients with liver metastases treated with immunotherapy, multivariate analysis showed that only the presence of peritoneal metastases was significantly associated with shorter PFS [hazard ratios (HR), 3.23; 95% CI, 1.12-9.32; P=0.030] and the patients with peritoneal metastases had shorter median PFS than patients without peritoneal metastases(3.1 vs 18.4 months; P=0.004), while the objective response rate was 100% in patients with HER2-positive (2 complete radiographic responses and 2 partial responses; 3 of 4 patients were still ongoing benefits [median follow-up time, 15.3 months ; interquartile range(IQR), 6.3-17.9 months]).ConclusionsThe findings suggest that patients with various types of gastric cancer liver metastases respond differently to immune checkpoint inhibitors, HER2-positive patients may derive clinical benefits from immune checkpoint inhibitors, while the presence of peritoneal metastases is associated with resistance.

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Section: Introductionmentioning

confidence: 99%

Prognostic characteristics and clinical response to immunotherapy targeting programmed cell death 1 for patients with advanced gastric cancer with liver metastases

Liang

Huang

et al. 2022

Front. Immunol.

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Immunotherapy for gastric cancer and liver metastasis: Is it time to bid farewell

Dehal

2024

World J Gastrointest Surg

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Patients with metastatic gastric cancer have a grim prognosis. Palliative chemotherapy offers a limited survival improvement, but recent advancements in immunotherapy have sparked hope. However, the effectiveness of immunotherapy in patients with liver metastases remains debated. This article reviews a recent study by Liu et al and evaluates conflicting evidence on the impact of liver metastases on response to immunotherapy in metastatic gastric cancer. While some studies suggest no significant difference in treatment response based on liver involvement, others report varied response rates. The present study, a retrospective analysis of 48 patients by Liu et al , examines this issue and concludes that immunotherapy is less effective in patients with liver metastases. Despite methodological limitations and a small sample size, the study contributes to the ongoing discourse. The nuanced response to immunotherapy in certain patients underscores the importance of understanding the tumor microenvironment, immune cell infiltration, and the expression of immune checkpoints. Rather than dismissing immunotherapy for patients with gastric cancer and liver metastases, a shift towards personalized treatment strategies and a more profound understanding of tumor-specific biomarkers is essential. By unraveling the molecular intricacies of individual cases, clinicians may tailor more effective and customized treatments, offering a glimmer of hope for this challenging patient group.

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P-86 First-line nivolumab (NIVO) plus chemotherapy (chemo) vs chemo in patients with advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC): CheckMate 649 Chinese subgroup analysis 2-year follow-up

Cited by 2 publications

References 0 publications

Prognostic characteristics and clinical response to immunotherapy targeting programmed cell death 1 for patients with advanced gastric cancer with liver metastases

Prognostic characteristics and clinical response to immunotherapy targeting programmed cell death 1 for patients with advanced gastric cancer with liver metastases

Immunotherapy for gastric cancer and liver metastasis: Is it time to bid farewell

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