Bao Zhe-Han, Hu Can, Zhang Yan-Qiang, Yu Peng-Cheng, Wang Yi, Xu Zhi-Yuan, Fu Huan-Ying, Cheng Xiang-Dong
Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou 310004, Zhejiang Province, China.
Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China.
World J Gastrointest Oncol. 2024 Apr 15;16(4):1281-1295. doi: 10.4251/wjgo.v16.i4.1281.
Gastric cancer (GC) is the fifth most common and the fourth most lethal malignant tumour in the world. Most patients are already in the advanced stage when they are diagnosed, which also leads to poor overall survival. The effect of postoperative adjuvant chemotherapy for advanced GC is unsatisfactory with a high rate of distant metastasis and local recurrence.
To investigate the safety and efficacy of a programmed cell death 1 (PD-1) inhibitor combined with oxaliplatin and S-1 (SOX) in the treatment of Borrmann large type III and IV GCs.
A retrospective analysis (IRB-2022-371) was performed on 89 patients with Borrmann large type III and IV GCs who received neoadjuvant therapy (NAT) from January 2020 to December 2021. According to the different neoadjuvant treatment regimens, the patients were divided into the SOX group (61 patients) and the PD-1 + SOX (P-SOX) group (28 patients).
The pathological response (tumor regression grade 0/1) in the P-SOX group was significantly higher than that in the SOX group (42.86% 18.03%, = 0.013). The incidence of ypN0 in the P-SOX group was higher than that in the SOX group (39.29% 19.67%, = 0.05). The use of PD-1 inhibitors was an independent factor affecting tumor regression grade. Meanwhile, the use of PD-1 did not increase postoperative complications or the adverse effects of NAT.
A PD-1 inhibitor combined with SOX could significantly improve the rate of tumour regression during NAT for patients with Borrmann large type III and IV GCs.
胃癌（GC）是全球第五大常见且第四大致命的恶性肿瘤。大多数患者在确诊时已处于晚期，这也导致总体生存率较低。晚期胃癌术后辅助化疗的效果并不理想，远处转移和局部复发率较高。
探讨程序性细胞死亡蛋白1（PD-1）抑制剂联合奥沙利铂和S-1（SOX）治疗BorrmannⅢ型和Ⅳ型胃癌的安全性和疗效。
对2020年1月至2021年12月期间接受新辅助治疗（NAT）的89例BorrmannⅢ型和Ⅳ型胃癌患者进行回顾性分析（IRB-2022-371）。根据不同的新辅助治疗方案，将患者分为SOX组（61例）和PD-1+SOX（P-SOX）组（28例）。
P-SOX组的病理反应（肿瘤退缩分级0/1）显著高于SOX组（42.86%对18.03%，P=0.013）。P-SOX组ypN0的发生率高于SOX组（39.29%对19.67%，P=0.05）。使用PD-1抑制剂是影响肿瘤退缩分级的独立因素。同时，使用PD-1并未增加术后并发症或新辅助治疗的不良反应。
PD-1抑制剂联合SOX可显著提高BorrmannⅢ型和Ⅳ型胃癌患者新辅助治疗期间的肿瘤退缩率。
