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)
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 ef...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-024-11972-w |
| _version_ | 1827327201183268864 |
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| author | Sung Hee Lim Keun-Wook Lee Jae-Joon Kim Hyeon-Su Im In-Ho Kim Hye Sook Han Dong-Hoe Koo Jang Ho Cho Chi Hoon Maeng Min-Young Lee Hyo Jin Lee Jwa Hoon Kim Sang Gon Park Joo Young Jung Seong-Hoon Shin Ki Hyang Kim Hyeyeong Kim So Yeon Oh Minsu Kang Minkyu Jung Sun Young Rha |
| author_facet | Sung Hee Lim Keun-Wook Lee Jae-Joon Kim Hyeon-Su Im In-Ho Kim Hye Sook Han Dong-Hoe Koo Jang Ho Cho Chi Hoon Maeng Min-Young Lee Hyo Jin Lee Jwa Hoon Kim Sang Gon Park Joo Young Jung Seong-Hoon Shin Ki Hyang Kim Hyeyeong Kim So Yeon Oh Minsu Kang Minkyu Jung Sun Young Rha |
| author_sort | Sung Hee Lim |
| collection | DOAJ |
| description | 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. Trial registration This study was registered in the Clinical Trial Registry of Korea ( https://cris.nih.go.kr : KCT 0007732). |
| first_indexed | 2024-03-07T14:56:38Z |
| format | Article |
| id | doaj.art-9274e12fab6e4e7e902af4a321c8f49d |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-07T14:56:38Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-9274e12fab6e4e7e902af4a321c8f49d2024-03-05T19:23:06ZengBMCBMC Cancer1471-24072024-02-0124111210.1186/s12885-024-11972-wReal-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)Sung Hee Lim0Keun-Wook Lee1Jae-Joon Kim2Hyeon-Su Im3In-Ho Kim4Hye Sook Han5Dong-Hoe Koo6Jang Ho Cho7Chi Hoon Maeng8Min-Young Lee9Hyo Jin Lee10Jwa Hoon Kim11Sang Gon Park12Joo Young Jung13Seong-Hoon Shin14Ki Hyang Kim15Hyeyeong Kim16So Yeon Oh17Minsu Kang18Minkyu Jung19Sun Young Rha20Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical CenterDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of MedicineDepartment of Internal Medicine, School of Medicine, Pusan National University Yangsan Hospital, Pusan National UniversityDepartment of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of MedicineDivision of Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of MedicineDepartment of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDivision of Oncology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, College of Medicine, Kyung Hee UniversityDivision of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Seoul HospitalDivision of Hemato-Oncology, Department of Internal Medicine, Chungnam National University HospitalDepartment of Internal Medicine, Anam Hospital, Korea University College of MedicineDepartment of Hemato-Oncology, Chosun University HospitalDivision of Hemato-Oncology, Hallym University Dongtan Sacred Heart HospitalDepartment of Hemato/Oncology, Internal Medicine, Kosin University Gospel HospitalDivision of Oncology, Department of Internal Medicine, Inje University College of Medicine, Busan Paik HospitalDepartment of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of MedicineDepartment of Internal Medicine, School of Medicine, Pusan National University Yangsan Hospital, Pusan National UniversityDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of MedicineDivision of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University Health SystemDivision of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University Health SystemAbstract 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. Trial registration This study was registered in the Clinical Trial Registry of Korea ( https://cris.nih.go.kr : KCT 0007732).https://doi.org/10.1186/s12885-024-11972-wGastric cancerThird-line treatmentIrinotecanNivolumabPembrolizumab |
| spellingShingle | Sung Hee Lim Keun-Wook Lee Jae-Joon Kim Hyeon-Su Im In-Ho Kim Hye Sook Han Dong-Hoe Koo Jang Ho Cho Chi Hoon Maeng Min-Young Lee Hyo Jin Lee Jwa Hoon Kim Sang Gon Park Joo Young Jung Seong-Hoon Shin Ki Hyang Kim Hyeyeong Kim So Yeon Oh Minsu Kang Minkyu Jung Sun Young Rha 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) BMC Cancer Gastric cancer Third-line treatment Irinotecan Nivolumab Pembrolizumab |
| title | 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) |
| title_full | 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) |
| title_fullStr | 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) |
| title_full_unstemmed | 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) |
| title_short | 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) |
| title_sort | 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 |
| topic | Gastric cancer Third-line treatment Irinotecan Nivolumab Pembrolizumab |
| url | https://doi.org/10.1186/s12885-024-11972-w |
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