eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
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3/2024
vol. 28
 
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abstract:
Review paper

Comparative efficacy of programmed death ligand 1 inhibition and chemotherapy in advanced gastric or gastroesophageal junction cancer with combined positive score – a meta-analysis

Zakari Shaibu
1, 2
,
Fumeng Yang
2
,
Liu Ting
2
,
Lily Dzidula
3
,
Amina Elmi Yusuf
4
,
Zhi-hong Chen
1
,
Wei Zhu
2

  1. Department of Gastrointestinal Surgery, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, 212002 Jiangsu People’s Republic of China
  2. School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
  3. Claremont Graduate University, School of Community and Global Health
  4. Department of Emergency Medicine, Second Affiliated Hospital of Nanjing Medical University
Contemp Oncol (Pozn) 2024; 28 (3): 183–190
DOI: https://doi.org/10.5114/wo.2024.144107
Online publish date: 2024/10/15
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Advanced gastric and gastroesophageal junction cancer (G/GEJC) poses significant therapeutic challenges. Immune checkpoint inhibitors, particularly targeting programmed cell death ligand-1 (PD-L1), have emerged as promising agents to enhance patient outcomes. This meta-analysis evaluates the efficacy of PD-L1 inhibitors compared to chemotherapy in patients with advanced G/GEJC characterised by varying combined positive scores (CPS). We systematically searched PubMed, Google Scholar, and Web of science for clinical trial studies comparing PD-L1 inhibitors and chemotherapy in CPS-positive patients, focusing on studies published up to 10 April 2023. Studies were evaluated with risk of bias tools. The primary clinical endpoint analysed in this study was overall survival (OS), and the secondary endpoint was progression-free survival (PFS). This study is registered with Prospero (CRD42023495607). A total of 10 studies comprising 4522 participants were included. Our analysis revealed no statistically significant difference in CPS values between PD-L1 inhibitors and chemotherapy groups (≥ 1 : 1.03 [95% CI: 0.86–1.24], ≤ 1 : 0.92 [95% CI: 0.77–1.11]). However, the pooled hazard ratio for OS favoured PD-L1 inhibitors (hazard ratios – HR, 0.83, [95% CI: 0.78–0.88] and p < 0.00001), while PFS was better after chemotherapy (HR 1.28, [95% CI: 1.04–1.58], p = 0.02). Program death ligand-1 inhibitors improve OS, while chemotherapy enhances PFS in advanced G/GEJC, warranting further investigation into the impact of CPS on treatment outcomes.
keywords:

gastric cancer, gastroeso­phageal adenocarcinoma, immune checkpoint inhibitors, chemotherapy, survival, immunotherapy
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