Association of the PD-L1 CPS With the Efficacy of First-Line Nivolumab Plus Chemotherapy for Unresectable Advanced or Recurrent Gastric Cancer.
The CheckMate 649 trial showed the superiority of first-line nivolumab plus chemotherapy (Nivo-CT) over chemotherapy alone for advanced gastric or gastroesophageal junction (GEJ) cancer with a programmed cell death-ligand 1 (PD-L1) combined positive score (CPS) ≥ 5. However, few studies have investigated the correlation between PD-L1 CPS and the efficacy of first-line Nivo-CT in the real-world setting.
This multicenter retrospective study included patients with unresectable advanced or recurrent gastric or GEJ cancer who were started on first-line Nivo-CT between December 2021 and December 2023 at any of four institutions in Japan. PD-L1 CPS was classified into three groups (< 1, 1 to < 5, and ≥ 5) before the start of Nivo-CT.
A total of 234 patients were included (median age 70 years; 64.5% male; 89.7% with gastric primary). PD-L1 CPS was < 1 in 35 patients (15.0%), 1 to < 5 in 76 (32.5%), and ≥ 5 in 123 (52.5%). Median follow-up was 14.0 months (range 2.3-30.3). Median overall survival was 18.7 (95% confidence interval [CI] 17.4-not reached), 23.4 (95% CI 17.7-not reached), and 18.3 months (95% CI 13.3-22.5), with objective response rates of 30.8%, 66.7%, and 61.3%. Multivariate analysis did not identify PD-L1 CPS as a prognostic factor, whereas an Eastern Cooperative Oncology Group performance status ≥ 1, a GEJ primary, and two or more metastatic sites were associated with poor prognosis.
The PD-L1 CPS had no significant effect on prognosis in patients with unresectable advanced or recurrent gastric or GEJ cancer treated with first-line Nivo-CT.
This multicenter retrospective study included patients with unresectable advanced or recurrent gastric or GEJ cancer who were started on first-line Nivo-CT between December 2021 and December 2023 at any of four institutions in Japan. PD-L1 CPS was classified into three groups (< 1, 1 to < 5, and ≥ 5) before the start of Nivo-CT.
A total of 234 patients were included (median age 70 years; 64.5% male; 89.7% with gastric primary). PD-L1 CPS was < 1 in 35 patients (15.0%), 1 to < 5 in 76 (32.5%), and ≥ 5 in 123 (52.5%). Median follow-up was 14.0 months (range 2.3-30.3). Median overall survival was 18.7 (95% confidence interval [CI] 17.4-not reached), 23.4 (95% CI 17.7-not reached), and 18.3 months (95% CI 13.3-22.5), with objective response rates of 30.8%, 66.7%, and 61.3%. Multivariate analysis did not identify PD-L1 CPS as a prognostic factor, whereas an Eastern Cooperative Oncology Group performance status ≥ 1, a GEJ primary, and two or more metastatic sites were associated with poor prognosis.
The PD-L1 CPS had no significant effect on prognosis in patients with unresectable advanced or recurrent gastric or GEJ cancer treated with first-line Nivo-CT.
Authors
Ogura Ogura, Ohnishi Ohnishi, Inamoto Inamoto, Kito Kito, Nagashima Nagashima, Takahashi Takahashi, Furuta Furuta, Shoji Shoji
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