Department of Onco-biological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan,
Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Oncology. 2020;98(9):630-636. doi: 10.1159/000507219. Epub 2020 May 19.
Nivolumab is recommended as a third-line treatment in patients with unresectable advanced or recurrent gastric cancer. Although recent studies have demonstrated the prognostic impact of salvage chemotherapy after immune checkpoint inhibitors in several malignancies, its clinical significance remains unclear in patients with gastric cancer. This study aimed to investigate tumor response to subsequent chemotherapy after nivolumab in patients with advanced gastric cancer and assess the prognostic effect of salvage chemotherapy.
We retrospectively enrolled 31 patients with unresectable advanced or recurrent gastric cancer receiving nivolumab.
Twenty-two and nine patients received nivolumab as third-line and fourth- to sixth-line treatments, respectively. The objective response rate (ORR) and disease control rate (DCR) to nivolumab were 20.0% (4/20) and 55.0% (11/20), respectively. Eleven patients received salvage chemotherapy after nivolumab. The ORR and DCR to salvage chemotherapy were 37.5% (3/8) and 75.0% (6/8), respectively. The median progression-free survival and overall survival following salvage chemotherapy were 285 and 360 days, respectively.
Our preliminary study indicates that nivolumab exposure may enhance subsequent chemosensitivity in patients with advanced gastric cancer.
纳武利尤单抗被推荐作为不可切除的晚期或复发性胃癌患者的三线治疗药物。尽管最近的研究表明，在几种恶性肿瘤中，免疫检查点抑制剂后的挽救化疗对预后有影响，但在胃癌患者中，其临床意义仍不清楚。本研究旨在探讨纳武利尤单抗治疗后晚期胃癌患者后续化疗的肿瘤反应，并评估挽救化疗的预后效果。
我们回顾性纳入了 31 名接受纳武利尤单抗治疗的不可切除的晚期或复发性胃癌患者。
22 名和 9 名患者分别接受纳武利尤单抗作为三线和四线至六线治疗。纳武利尤单抗的客观缓解率（ORR）和疾病控制率（DCR）分别为 20.0%（4/20）和 55.0%（11/20）。11 名患者在接受纳武利尤单抗治疗后接受了挽救化疗。挽救化疗的 ORR 和 DCR 分别为 37.5%（3/8）和 75.0%（6/8）。挽救化疗后的中位无进展生存期和总生存期分别为 285 天和 360 天。
我们的初步研究表明，纳武利尤单抗暴露可能增强晚期胃癌患者后续化疗的敏感性。
