Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis

Background: Perioperative chemotherapy (CT) is an established therapeutic approach for patients diagnosed with stage IB–III gastric cancer (GC). Objectives: This study aimed to investigate the efficacy of this approach in individuals with GC exhibiting high microsatellite instability (MSI-H). Design...

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Main Authors: Fausto Petrelli, Maria Antista, Francesca Marra, Fulvia Milena Cribiu’, Valentina Rampulla, Filippo Pietrantonio, Lorenzo Dottorini, Michele Ghidini, Andrea Luciani, Alberto Zaniboni, Gianluca Tomasello
Format: Article
Language:English
Published: SAGE Publishing 2024-02-01
Series:Therapeutic Advances in Medical Oncology
Online Access:https://doi.org/10.1177/17588359241231259
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author Fausto Petrelli
Maria Antista
Francesca Marra
Fulvia Milena Cribiu’
Valentina Rampulla
Filippo Pietrantonio
Lorenzo Dottorini
Michele Ghidini
Andrea Luciani
Alberto Zaniboni
Gianluca Tomasello
author_facet Fausto Petrelli
Maria Antista
Francesca Marra
Fulvia Milena Cribiu’
Valentina Rampulla
Filippo Pietrantonio
Lorenzo Dottorini
Michele Ghidini
Andrea Luciani
Alberto Zaniboni
Gianluca Tomasello
author_sort Fausto Petrelli
collection DOAJ
description Background: Perioperative chemotherapy (CT) is an established therapeutic approach for patients diagnosed with stage IB–III gastric cancer (GC). Objectives: This study aimed to investigate the efficacy of this approach in individuals with GC exhibiting high microsatellite instability (MSI-H). Design: A systematic review was conducted, including studies that provided data on (neo)adjuvant CT outcomes in patients with MSI-H GC. Methods: Systematic searches were conducted in PubMed, Cochrane Central of Controlled Trials, and Embase databases. Data were aggregated using hazard ratios (HRs) to compare overall survival between CT and surgery. Results: Data analysis from 23 studies, including 22,011 patients, revealed that the prevalence of MSI-H is 9.8%. Administration of adjuvant or perioperative CT did not significantly reduce the risk of death or relapse in patients with MSI-H GC (HR = 0.8, 95% CI 0.54–1.16; p = 0.24 and HR = 0.84, 95% CI 0.59–1.18; p = 0.31, respectively). Conclusion: Chemotherapy did not benefit patients diagnosed with MSI-H nonmetastatic GC but rather will be integrated with immune checkpoint inhibitors in the near future.
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spelling doaj.art-e83636b6e76e40ea8837189179a8dafe2024-03-01T19:04:26ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592024-02-011610.1177/17588359241231259Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysisFausto PetrelliMaria AntistaFrancesca MarraFulvia Milena Cribiu’Valentina RampullaFilippo PietrantonioLorenzo DottoriniMichele GhidiniAndrea LucianiAlberto ZaniboniGianluca TomaselloBackground: Perioperative chemotherapy (CT) is an established therapeutic approach for patients diagnosed with stage IB–III gastric cancer (GC). Objectives: This study aimed to investigate the efficacy of this approach in individuals with GC exhibiting high microsatellite instability (MSI-H). Design: A systematic review was conducted, including studies that provided data on (neo)adjuvant CT outcomes in patients with MSI-H GC. Methods: Systematic searches were conducted in PubMed, Cochrane Central of Controlled Trials, and Embase databases. Data were aggregated using hazard ratios (HRs) to compare overall survival between CT and surgery. Results: Data analysis from 23 studies, including 22,011 patients, revealed that the prevalence of MSI-H is 9.8%. Administration of adjuvant or perioperative CT did not significantly reduce the risk of death or relapse in patients with MSI-H GC (HR = 0.8, 95% CI 0.54–1.16; p = 0.24 and HR = 0.84, 95% CI 0.59–1.18; p = 0.31, respectively). Conclusion: Chemotherapy did not benefit patients diagnosed with MSI-H nonmetastatic GC but rather will be integrated with immune checkpoint inhibitors in the near future.https://doi.org/10.1177/17588359241231259
spellingShingle Fausto Petrelli
Maria Antista
Francesca Marra
Fulvia Milena Cribiu’
Valentina Rampulla
Filippo Pietrantonio
Lorenzo Dottorini
Michele Ghidini
Andrea Luciani
Alberto Zaniboni
Gianluca Tomasello
Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis
Therapeutic Advances in Medical Oncology
title Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis
title_full Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis
title_fullStr Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis
title_full_unstemmed Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis
title_short Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis
title_sort adjuvant and neoadjuvant chemotherapy for msi early gastric cancer a systematic review and meta analysis
url https://doi.org/10.1177/17588359241231259
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