晚期胃癌化疗策略的变化及其对预后的影响。
Changes in Chemotherapeutic Strategies and Their Prognostic Impact in Patients With Advanced Gastric Cancer.
机构信息
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.
出版信息
In Vivo. 2022 Jan-Feb;36(1):409-415. doi: 10.21873/invivo.12718.
BACKGROUND/AIM: To investigate changes in post-progression chemotherapy (PPC) before and after nivolumab approval and determine their prognostic impact.
PATIENTS AND METHODS
A total of 146 patients with unresectable gastric cancer who had at least progressive disease after first- and/or second-line chemotherapy were retrospectively enrolled.
RESULTS
Among the 146 patients, 46 and 23 received ramucirumab and nivolumab, respectively. Moreover, 95 and 62 patients received PPC after first- and second-line chemotherapy, respectively. Group B (i.e., at least chemotherapy after nivolumab approval) had significantly higher proportions of patients receiving ramucirumab therapy, nivolumab therapy, and PPC after first- or second-line chemotherapy compared to group A (i.e., termination of chemotherapy before nivolumab approval). Group A had significantly poorer prognosis than group B. Multivariate analysis showed that age, number of distant metastatic sites, and ramucirumab therapy were independent prognostic factors.
CONCLUSION
Changes in chemotherapeutic strategies, including PPC, might contribute to improved prognosis in patients with advanced gastric cancer.
背景/目的：探讨纳武利尤单抗（nivolumab）获批前后后线化疗（PPC）的变化及其对预后的影响。
患者和方法
共纳入 146 例不可切除的胃癌患者，这些患者在一线和/或二线化疗后至少发生了疾病进展。
结果
在这 146 例患者中，46 例和 23 例患者分别接受了雷莫芦单抗和纳武利尤单抗治疗。此外，95 例和 62 例患者分别在一线和二线化疗后接受了 PPC。与 A 组（即在纳武利尤单抗获批前停止化疗）相比，B 组（即在纳武利尤单抗获批后至少接受了化疗）中接受雷莫芦单抗治疗、纳武利尤单抗治疗和一线或二线化疗后 PPC 的患者比例显著更高。A 组的预后明显差于 B 组。多因素分析显示，年龄、远处转移部位数量和雷莫芦单抗治疗是独立的预后因素。
结论
化疗策略的改变，包括 PPC，可能有助于改善晚期胃癌患者的预后。
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