Department of Rheumatology and Immunology, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050011, P.R. China.
Department of Gastroenterology and Hepatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, P.R. China.
BMC Cancer. 2024 Oct 18;24(1):1292. doi: 10.1186/s12885-024-13063-2.
Gastric cancer is a significant global malignancy with poor prognosis. Although the emergence of immune checkpoint inhibitors (ICIs) prolonged the duration of survival, resistance and progression are inevitable. We aim to evaluate the effectiveness of programmed death-1 (PD-1) inhibitors in immunotherapy beyond progression (IBP).
We divided the advanced gastric cancer patients who received two lines immunotherapy into same regimen group (with same PD-1 inhibitor regime after IBP) and different regimen group (with different PD-1 inhibitor regime after IBP). Statistical analysis conducted to compare patient characteristics and evaluate survival differences between groups.
The clinical outcome analysis showed that the same PD-1 inhibitor regime seemed to exhibit a higher disease control rate (DCR) (51.8% vs. 29.2%, P = 0.062), significantly prolonged progression-free survival 2 (PFS2) (162 vs. 75 days, P = 0.001) and overall survival (OS) (312 vs. 166 days, P = 0.022) when compared with those of cross line. In the multivariate analysis, when using different regimen group as reference, the same regimen group was found to be independently associated with improved PFS2 [hazard ratio (HR) = 0.467, 95% confidence interval (CI): 0.267-0.816, P = 0.008] and OS (HR = 0.508, 95%CI: 0.278-0.927, P = 0.027).
Continuation of the same type of PD-1 inhibitor regime in IBP shows clinical benefits and represents a promising therapeutic approach.
胃癌是一种具有不良预后的重大全球性恶性肿瘤。尽管免疫检查点抑制剂（ICIs）的出现延长了生存时间，但耐药性和进展是不可避免的。我们旨在评估 PD-1 抑制剂在免疫治疗后进展（IBP）中的疗效。
我们将接受二线免疫治疗的晚期胃癌患者分为同方案组（IBP 后使用相同的 PD-1 抑制剂方案）和不同方案组（IBP 后使用不同的 PD-1 抑制剂方案）。进行统计分析比较患者特征，并评估两组之间的生存差异。
临床结果分析表明，同 PD-1 抑制剂方案似乎具有更高的疾病控制率（DCR）（51.8%比 29.2%，P=0.062），显著延长无进展生存期 2（PFS2）（162 比 75 天，P=0.001）和总生存期（OS）（312 比 166 天，P=0.022）。多变量分析显示，当以不同方案组为参照时，同方案组与改善的 PFS2 相关（风险比 [HR] = 0.467，95%置信区间 [CI]：0.267-0.816，P=0.008）和 OS（HR = 0.508，95%CI：0.278-0.927，P=0.027）。
在 IBP 中继续使用相同类型的 PD-1 抑制剂方案显示出临床获益，代表了一种有前途的治疗方法。
