Efficacy and Safety of Immune Checkpoint Inhibitors Therapy on Advanced Gastric Cancer or Gastroesophageal Junction Cancer: A Meta-analysis

Abstract

Objective To systematically evaluate the efficacy and safety of immune checkpoint inhibitors in the treatment of advanced gastric cancer or gastroesophageal junction cancer (GC/GEJC). Methods CNKI, Wanfang, PubMed, EMBASE, ClinicalTrials, Cochrane Library and other databases were searched to collect the clinical trials of immune checkpoint inhibitors in the treatment of advanced GC/GEJC. The retrieval time was from the inception to Nov. 2019. Outcome measures mainly included ORR, DCR, PFS, OS and toxicities. The adoption rate difference and hazard ratio were effect measures. Meta-analysis was performed using RevMan 5.3 software. Results We included seven literatures with a total of 1949 patients. Meta-analysis showed that for the patients with advanced GC/GEJC, the second-line or later immune checkpoint inhibitor therapy improved the overall survival rate at 12 and 18 months; the OS of the patients was prolonged, compared with chemotherapy/placebo therapy (all P < 0.05). The incidence of adverse reactions of any grade or ≥grade 3 caused by immune checkpoint inhibitor therapy was lower than that caused by chemotherapy/placebo. Conclusion Immune checkpoint inhibitor treatment could improve survival endpoints in some patients with advanced GC/GEJC, and the incidence of common adverse reactions is low.

Keywords

• advanced gastric cancer
• advanced gastroesophageal junction cancer
• immune checkpoint inhibitors
• chemotherapy
• placebo
• effectiveness
• safety
• meta-analysis