Nakayama Yurika, Ando Takayuki, Takahashi Naoki, Tsukada Kenichiro, Takagi Hiroaki, Goto Yuno, Nakaya Atsuko, Nakada Naokatsu, Yoshita Hiroki, Motoo Iori, Ueda Akira, Ueda Yuko, Sakumura Miho, Kajiura Shinya, Ogawa Kohei, Hosokawa Ayumu, Yasuda Ichiro
Third Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
Department of Gastroenterology, Kouseiren Takaoka Hospital, 5-10 Eirakumachi, Takaoka-shi 933-8555, Japan.
J Clin Med. 2024 Jan 31;13(3):834. doi: 10.3390/jcm13030834.
(1) : Nivolumab plus chemotherapy is established as a first-line treatment for advanced gastric cancer (AGC). While mFOLFOX6 is commonly used for AGC with severe peritoneal metastasis, the efficacy of nivolumab combined with it remains uncertain. We evaluated the outcomes of nivolumab plus mFOLFOX6 for AGC with severe peritoneal metastasis in clinical practice. (2) : This multicenter retrospective study was conducted between December 2021 and June 2023. We investigated AGC patients with massive ascites or inadequate oral intake due to severe peritoneal metastasis and who received nivolumab plus mFOLFOX6. (3) : Among 106 patients treated with nivolumab plus chemotherapy, 21 (19.8%) had severe peritoneal metastasis, with 14 receiving nivolumab plus mFOLFOX6. The median progression-free survival was 7.4 months (95%CI 1.9-10.1), and the median overall survival was 10.7 months (95%CI 5.3-NA), with four patients (28.5%) surviving more than 12 months. Improved ascites and oral intake were observed in 6/14 patients (42.8%) and 10/11 patients (90.9%), respectively. The major grade 3 or more adverse events included leukopenia (28.5%) and neutropenia (21.4%), with no severe immune-related adverse events reported. (4) : The safety and moderate efficacy of nivolumab plus mFOLFOX6 were suggested even in AGC patients with severe peritoneal metastasis.
(1)：纳武利尤单抗联合化疗已被确立为晚期胃癌（AGC）的一线治疗方案。虽然mFOLFOX6常用于治疗伴有严重腹膜转移的AGC，但纳武利尤单抗联合mFOLFOX6的疗效仍不确定。我们评估了在临床实践中纳武利尤单抗联合mFOLFOX6治疗伴有严重腹膜转移的AGC的疗效。(2)：这项多中心回顾性研究于2021年12月至2023年6月期间进行。我们调查了因严重腹膜转移而出现大量腹水或口服摄入量不足且接受纳武利尤单抗联合mFOLFOX6治疗的AGC患者。(3)：在106例接受纳武利尤单抗联合化疗的患者中，21例（19.8%）有严重腹膜转移，其中14例接受了纳武利尤单抗联合mFOLFOX6治疗。无进展生存期的中位数为7.4个月（95%CI 1.9 - 10.1），总生存期的中位数为10.7个月（95%CI 5.3 - NA），4例患者（28.5%）存活超过12个月。分别在6/14例患者（42.8%）和10/11例患者（90.9%）中观察到腹水改善和口服摄入量增加。3级或更高级别的主要不良事件包括白细胞减少（28.5%）和中性粒细胞减少（21.4%），未报告严重的免疫相关不良事件。(4)：即使在伴有严重腹膜转移的AGC患者中，纳武利尤单抗联合mFOLFOX6也显示出安全性和一定疗效。
