BACKGROUND: This study aims to compare the efficacy between neoadjuvant immune checkpoint inhibitors (ICIs) plus chemotherapy vs . chemotherapy, and neoadjuvant triplet vs . doublet chemotherapeutic regimens in locally advanced gastric/esophagogastric junction cancer (LAGC). METHODS: We included LAGC patients from 47 hospitals in China's National Cancer Information Database (NCID) from January 2019 to December 2022. Using propensity score matching (PSM), we retrospectively analyzed the efficacy between neoadjuvant ICIs plus chemotherapy vs . chemotherapy alone, and neoadjuvant triplet vs . doublet chemotherapeutic regimens. The primary study result was the pathologic complete response (pCR) rate. The secondary study results were disease-free survival (DFS) and overall survival (OS). RESULTS: A total of 1205 LAGC patients were included. After PSM, the ICIs plus chemotherapy and the chemotherapy cohorts had 184 patients each, while the doublet and triplet chemotherapy cohorts had 246 patients each. The pCR rate (14.13% vs . 7.61%, χ2 = 4.039, P = 0.044), and the 2-year (77.60% vs . 61.02%, HR = 0.67, 95% con-fidence interval [CI] 0.43-0.98, P = 0.048) and 3-year (70.55% vs . 61.02%, HR = 0.58, 95% CI 0.32-0.93, P = 0.048) DFS rates in the ICIs plus chemotherapy cohort were improved compared to those in the chemotherapy cohort. No significant increase was observed in the OS rates at both 1 year and 2 years. The pCR rates, DFS rates at 1-3 years, and OS rates at 1-2 years did not differ significantly between the doublet and triplet cohorts, respectively. No differences were observed in postoperative complications between any of the group comparisons. CONCLUSIONS Neoadjuvant ICIs plus chemotherapy improved the pCR rate and 2-3 years DFS rates of LAGC compared to chemotherapy alone, but whether short-term benefit could translate into long-term efficacy is unclear. The triplet regimen was not superior to the doublet regimen in terms of efficacy. The safety after surgery was similar between either ICIs plus chemotherapy and chemotherapy or the triplet and the doublet regimen.
Humans ; Stomach Neoplasms/metabolism* ; Female ; Neoadjuvant Therapy/methods* ; Immune Checkpoint Inhibitors/therapeutic use* ; Male ; Middle Aged ; Propensity Score ; Retrospective Studies ; Aged ; Receptor, ErbB-2/metabolism* ; Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Disease-Free Survival ; Cohort Studies

Objective To investigate the clinical manifestations and potential prognostic factors of neuroendocrine tumors of the thymus (NETT).Methods The clinical data of 139 patients with pathologically confirmed NETT from the Surveillance,Epidemiology,and End Results (SEER) database in National Cancer Institute between January 2007 and December 2014 were retrospectively analyzed.Cox proportional hazard regression was used to assess the prognostic influencing factors of NETT.Results The median age at diagnosis of 139 patients with NETT was 59 years old,and age was (58±17) years old.There were 95 males and 44 females,and the ratio was 2.2 ∶ 1.The median overall survival time was 90 months.Univariate analysis showed that the tumor stage (P =0.001),the tumor grade (P =0.001) and the surgery (P =0.003) were associated with prognosis.Multivariate analysis showed that the tumor grade was the independent prognostic factor for the patients with NETT (HR:5.70;95％ CI 1.75-18.58;P =0.004).Conclusion NETT is a rare malignancy with tremendous aggressiveness.Tumor grade is an independent risk factor for the prognosis of the patients with NETT,and the prognosis of well-differentiated patients is better than that of poorly differentiated patients.