Clinical efficacy of neoadjuvant immunochemotherapy versus neoadjuvant chemotherapy for local advanced gastric adenocarcinoma
10.16016/j.2097-0927.202405076
- VernacularTitle:新辅助免疫化疗对比新辅助化疗用于局部进展期胃癌的临床疗效分析
- Author:
Lei WANG
1
,
2
;
Linghong WAN
;
Tao WANG
;
Zhongyi QIN
;
Fan LI
;
Wenkang LIU
;
Bin WANG
Author Information
1. 400042 重庆,陆军军医大学(第三军医大学)陆军特色医学中心消化内科,消化系统肿瘤精准防治重庆市重点实验室
2. 213003 江苏 常州,联勤保障部队第九○四医院常州医疗区
- Keywords:
gastric cancer;
neoadjuvant therapy;
immunotherapy;
Lauren's classification
- From:
Journal of Army Medical University
2024;46(20):2313-2321
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the therapeutic efficacies of neoadjuvant immunochemotherapy (NAIC )and neoadjuvant chemotherapy (NAC )for local advanced gastric adenocarcinoma and analyze the clinicopathological characteristics.Methods A retrospective cohort study was conducted on 243 patients with locally advanced gastric cancer admitted in Army Medical Center of PLA (Daping Hospital)and the First Affiliated Hospital of China Medical University from January 2017 to July 2023. After balancing the confounding factors by inclusion and exclusion criteria and propensity score matching (PSM),the tumor pathological regression (TRG)rate and safety of the 2 neoadjuvant treatment regimens were analyzed,and the clinical pathological characteristics were analyzed to find clinical pathological characteristics related to efficacy.Results After using PSM to balance the baseline characteristics of the 2 groups of patients,53 subjects in each group were included in the analysis.In terms of TRG,the pathological complete response (pCR)rate in the NAIC group (13 patients,25％)was significantly higher than that in the NAC group (2 patients,3.8％,P<0.05 ).Similar results were observed in terms of major pathological response (MPR),with 23 patients (43％)in the NAIC group achieving MPR,while 9 patients (17％)in the NAC group achieved MPR (P<0.05 ).In terms of safety,the incidence of treatment-related adverse events (TRAEs) of any grade in the NAIC group and the NAC group was comparable (96.2％ and 96.2％,respectively).In an exploratory subgroup analysis of tumor pathological regression,the patients with clinicopathological features such as age<65 years,male,stage Ⅲ～Ⅳ A of American Joint Committee on Cancer (AJCC)staging,histological type of adenocarcinoma,high-moderate differentiated,intestinal-type gastric cancer,stage T3～4 of clinical T-staging,and stage N2～3 of clinical N-staging were more likely to benefit from NAIC.Conclusion NAIC results in a higher rate of pathological regression and a comparable incidence of adverse events when compared with chemotherapy alone for patients with local advanced gastric adenocarcinoma.
