Real-world outcomes of third-line immune checkpoint inhibitors versus irinotecan-based chemotherapy in patients with advanced gastric cancer: a Korean, multicenter study (KCSG ST22-06)open access
- Authors
- Lim, Sung Hee; Lee, Keun-Wook; Kim, Jae-Joon; Im, Hyeon-Su; Kim, In-Ho; Han, Hye Sook; Koo, Dong-Hoe; Cho, Jang Ho; Maeng, Chi Hoon; Lee, Min-Young; Lee, Hyo Jin; Kim, Jwa Hoon; Park, Sang Gon; Jung, Joo Young; Shin, Seong-Hoon; Kim, Ki Hyang; Kim, Hyeyeong; Oh, So Yeon; Kang, Minsu; Jung, Minkyu; Rha, Sun Young
- Issue Date
- Feb-2024
- Publisher
- BMC
- Keywords
- Gastric cancer; Third-line treatment; Irinotecan; Nivolumab; Pembrolizumab
- Citation
- BMC CANCER, v.24, no.1
- Journal Title
- BMC CANCER
- Volume
- 24
- Number
- 1
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/26328
- DOI
- 10.1186/s12885-024-11972-w
- ISSN
- 1471-2407
1471-2407
- Abstract
- Background Immune checkpoint inhibitor (ICI) or irinotecan-based chemotherapy is frequently used after failure of second-line paclitaxel plus ramucirumab treatment for patients with locally advanced unresectable or metastatic advanced gastric cancer (AGC). This study aimed to compare the efficacy between ICI and irinotecan-based chemotherapy as third-line treatment in patients with AGC. Methods We retrospectively reviewed patients with AGC, whose third-line treatment started between July 2019 and June 2021 at 17 institutions in Korea. The ICI group included patients who received nivolumab or pembrolizumab, and the irinotecan-based chemotherapy group included patients who received irinotecan or FOLFIRI (5-fluorouracil, leucovorin and irinotecan). Results A total of 363 patients [n = 129 (ICI) and n = 234 (irinotecan-based chemotherapy)] were analyzed. The median progression-free survival was 2.3 and 2.9 months in ICI and irinotecan-based chemotherapy groups, respectively (p = 0.802). The median overall survival (OS) was 5.5 and 6.0 months in ICI and irinotecan-based chemotherapy groups, respectively (p = 0.786). For all patients included in this study, multivariable analysis showed that weight loss, peritoneal metastasis, low serum sodium or albumin, and short duration of second-line treatment were associated with inferior OS (p < 0.05). ICI showed significantly longer OS than irinotecan-based chemotherapy in patients without peritoneal metastasis. Whereas ICI showed significantly shorter OS in patients without PD-L1 expression than irinotecan-based chemotherapy. Conclusions No significant difference in survival outcome was observed between ICI and irinotecan-based chemotherapy as third-line treatment for AGC patients. ICI might be preferred for patients without peritoneal metastasis and irinotecan-based chemotherapy for patients with tumors without PD-L1 expression.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
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