Checkpoint inhibitors in metastatic gastric and GEJ cancer: a multi-institutional retrospective analysis of real-world data in a Western cohort
Verena Schlintl,
Florian Huemer,
Gabriel Rinnerthaler,
Thomas Melchardt,
Thomas Winder,
Patrick Reimann,
Jakob Riedl,
Arno Amann,
Wolfgang Eisterer,
Franz Romeder,
Gudrun Piringer,
Aysegül Ilhan-Mutlu,
Ewald Wöll,
Richard Greil,
Lukas Weiss
Affiliations
Verena Schlintl
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University
Florian Huemer
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University
Gabriel Rinnerthaler
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University
Thomas Melchardt
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University
Thomas Winder
Department of Internal Medicine II, Academic Teaching Hospital Feldkirch
Patrick Reimann
Department of Internal Medicine II, Academic Teaching Hospital Feldkirch
Jakob Riedl
Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz
Arno Amann
Department of Internal Medicine V, Medical University Innsbruck
Wolfgang Eisterer
Department of Internal Medicine and Oncology, Klagenfurt Hospital
Franz Romeder
Internal Medicine I: Department of Medical Oncology and Haematology, Ordensklinikum Linz Barmherzige Schwestern
Gudrun Piringer
Department of Internal Medicine IV, Wels-Grieskirchen Hospital, Wels, Austria and Johannes Kepler University Linz
Aysegül Ilhan-Mutlu
Department of Medicine I, Comprehensive Cancer Center Vienna, Gastroesophageal Tumor Unit, Medical University of Vienna
Ewald Wöll
Department of Internal Medicine, St. Vinzenz Hospital
Richard Greil
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University
Lukas Weiss
Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University
Abstract Background Safety and efficacy of immune checkpoint inhibitors in advanced gastric or gastroesophageal junction (GEJ) cancer could be demonstrated in predominantly Asian cohorts, whereas data in Western patients outside of clinical trials are vastly missing. Methods In this multi-institutional retrospective analysis conducted at nine oncologic centers in Austria, we tried to assess feasibility of checkpoint inhibitors in advanced gastric/GEJ cancer in a real-world Western cohort. Results In total, data from 50 patients with metastatic gastric/GEJ cancer who received nivolumab or pembrolizumab in a palliative setting between November 2015 and April 2020 have been evaluated. The median number of previous palliative therapy lines was two. The median progression-free survival (PFS) and overall survival (OS) were 2.1 (95% CI: 1.4–2.8) and 6.3 (95% CI: 3.3–9.3) months, respectively. There was no statistically significant difference in median OS according to microsatellite or PD-L1 status. However, a trend towards prolonged PFS and OS for the microsatellite instability high subgroup could be observed. Patients with an ECOG Performance Status (PS) ≥ 2 displayed a significantly worse outcome than those with an ECOG PS ≤ 1 (p = .03). Only one patient discontinued immunotherapy due to treatment-related toxicity. Conclusions Our results support feasibility of nivolumab and pembrolizumab in pre-treated patients with metastatic gastric and GEJ cancer in a Western real-world cohort. Further phase II/III studies are needed to confirm clinical efficacy.
