The short-term efficacy of neoadjuvant SOX versus SOX plus immune checkpoint inhibitor following laparoscopic gastrectomy for locally advanced gastric cancer: a multicenter retrospective cohort study in China.

IF 4.6 2区 医学 Q2 IMMUNOLOGY Cancer Immunology, Immunotherapy Pub Date : 2024-09-05 DOI:10.1007/s00262-024-03802-6
Hao Cui, Yongpu Yang, Liqiang Song, Zhen Yuan, Linde Sun, Jiajun Du, Yuyuan Lu, Ning Ning, Jianxin Cui, Yan Shi, Lin Chen, Bo Wei
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Abstract

Background: This study aims to evaluate the short-term efficacy for locally advanced gastric cancer (LAGC) who accepted laparoscopic gastrectomy (LG) after neoadjuvant SOX versus SOX plus immune checkpoint inhibitors (ICIs).

Methods: LAGC patients who accepted LG after neoadjuvant SOX (SOX-LG, n = 169) and SOX plus ICIs (SOX + ICIs-LG, n = 140) in three medical centers between Jan 2020 and Mar 2024 were analyzed. We compared the tumor regression, treatment-related adverse events (TRAEs), perioperative safety between two groups, and explored the risk factors of postoperative complications (POCs) for LG after neoadjuvant therapy.

Results: The baseline characteristics were comparable between two groups (P > 0.05). SOX + ICIs-LG group acquired a higher proportion of objective response (63.6% vs. 46.7%, P = 0.003), major pathological response (43.6% vs. 31.4%, P = 0.001), and pathological complete response (17.9% vs. 9.5%, P = 0.030). There were no significant differences in the TRAEs rates, operation time, R0 resection, retrieved lymph nodes, postoperative first flatus, and hospitalized days, overall and severe POCs between two groups (P > 0.05). Patients in the SOX-ICIs-LG group had lower estimated blood loss (EBL) compared with SOX-LG (P = 0.001). Multivariate analysis showed that more EBL (P = 0.003) and prognostic nutritional index (PNI) < 40 (P = 0.005) were independent risk factors of POCs for LG after neoadjuvant therapy.

Conclusion: Neoadjuvant SOX plus ICIs brings better tumor regression and similar TRAEs compared with SOX alone for LAGC. SOX + ICIs-LG is safe and feasible to conduct with less EBL. Surgeons should focus on the perioperative management to control POCs for patients with PNI < 40 and more EBL.

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中国一项多中心回顾性队列研究:局部晚期胃癌腹腔镜胃切除术后新辅助SOX与SOX加免疫检查点抑制剂的短期疗效比较。
研究背景本研究旨在评估接受腹腔镜胃切除术(LG)的局部晚期胃癌(LAGC)患者在新辅助SOX与SOX加免疫检查点抑制剂(ICIs)治疗后的短期疗效:分析了2020年1月至2024年3月期间在三家医疗中心接受新辅助SOX(SOX-LG,n = 169)和SOX加ICIs(SOX + ICIs-LG,n = 140)后腹腔镜胃切除术(LG)的LAGC患者。我们比较了两组患者的肿瘤消退情况、治疗相关不良事件(TRAEs)、围手术期安全性,并探讨了新辅助治疗后LG术后并发症(POCs)的风险因素:结果:两组患者的基线特征具有可比性(P>0.05)。SOX+ICIs-LG组获得客观反应(63.6% vs. 46.7%,P = 0.003)、主要病理反应(43.6% vs. 31.4%,P = 0.001)和病理完全反应(17.9% vs. 9.5%,P = 0.030)的比例更高。两组患者的TRAEs率、手术时间、R0切除率、淋巴结取回率、术后首次排便率、住院天数、总体POCs和严重POCs无明显差异(P > 0.05)。与SOX-LG组相比,SOX-ICIs-LG组患者的估计失血量(EBL)更低(P = 0.001)。多变量分析显示,EBL(P = 0.003)和预后营养指数(PNI)更高:与单用 SOX 治疗 LAGC 相比,新辅助 SOX 加 ICIs 能带来更好的肿瘤消退效果和相似的 TRAEs。SOX+ICIs-LG安全可行,EBL较低。外科医生应重视围手术期管理,以控制 PNI 患者的 POCs
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来源期刊
CiteScore
10.50
自引率
1.70%
发文量
207
审稿时长
1 months
期刊介绍: Cancer Immunology, Immunotherapy has the basic aim of keeping readers informed of the latest research results in the fields of oncology and immunology. As knowledge expands, the scope of the journal has broadened to include more of the progress being made in the areas of biology concerned with biological response modifiers. This helps keep readers up to date on the latest advances in our understanding of tumor-host interactions. The journal publishes short editorials including "position papers," general reviews, original articles, and short communications, providing a forum for the most current experimental and clinical advances in tumor immunology.
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