[Real World Impact of Immunotherapy in Patients with Unresectable Gastric Cancer].

Q4 Medicine Japanese Journal of Cancer and Chemotherapy Pub Date : 2024-10-01
Takahiro Ryuzaki, Takako Sentsui, Seiji Kobayashi, Yukimasa Miyazawa, Soichiro Tsukamoto, Hirokazu Murayama, Hisami Yamakawa, Ryohei Kanamaru, Yoshio Koide, Yoshiji Watanabe, Tsutomu Yarita, Hisahiro Matsubara
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Abstract

[Objective]To clarify the effect of immunotherapy on unresectable gastric cancer. [Subjects and methods]The study included all 67 patients with gastric cancer cStage ⅣB treated with systemic chemotherapy at Yarita Hospital between January 2016 and December 2022. The following 2 groups were compared: early patients treated between 2016 and 2017 and late patients treated between 2018 and 2022. [Results]Nivolumab was used in 20 patients(30%), and there were no cases of discontinuation due to irAE. The median overall survival was 11 months(0-91 months), with a duration of 13 months in the early group and 8.5 months in the late group(p=0.02). The transition rate to the third-line or later treatments increased from 6 of 27 patients(22%)in the early group to 13 of 40 patients(33%)in the late group(p=0.02). [Discussion]For patients evaluated in this study, the first and second treatment courses were introduced in the short-term, with the hope of subsequent treatment, even for patients with large ascites, poor PS, or complications. In recent years, drugs for the fourth-line and later treatments have been introduced, and we have observed patients for whom the latter treatment was effective.[Conclusion]The transition rate to the third-line or later treatments of patients with unresectable gastric cancer is increasing.

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[免疫疗法对无法切除的胃癌患者的实际影响]。
[目的]明确免疫疗法对不可切除胃癌的影响。[研究对象和方法]该研究纳入了2016年1月至2022年12月期间在Yarita医院接受全身化疗的所有67例ⅣB期胃癌患者。比较以下2组患者:2016年至2017年接受治疗的早期患者和2018年至2022年接受治疗的晚期患者。[结果]20例患者(30%)使用了Nivolumab,没有因irAE而停药的病例。中位总生存期为11个月(0-91个月),早期组为13个月,晚期组为8.5个月(P=0.02)。转为三线或更高治疗的比例从早期组的27例患者中的6例(22%)增加到晚期组的40例患者中的13例(33%)(P=0.02)。[讨论]对于本研究中评估的患者,第一和第二疗程是在短期内引入的,即使是腹水较大、PS 较差或有并发症的患者,也有希望接受后续治疗。结论]不可切除胃癌患者向三线或后期治疗过渡的比例正在增加。
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