A systematic review and meta-analysis of PD-1/PD-L1 inhibitors in specific patient subgroups with advanced gastro-oesophageal junction and gastric adenocarcinoma.
BACKGROUND
immune checkpoint inhibitors(ICIs) have shown contradictory results in patients with advanced gastro-oesophageal junction/gastric cancer(GOJ/GC).


AIM
to identify specific patient subgroups that would derive survival benefit from ICIs.


METHODS
a subgroup meta-analysis of randomised clinical trials(RCTs) was carried out.


RESULTS
four phase-III-RCTs were identified with data on the following variables: primary location(Gastric vs GOJ); age(≤ 65 vs >65); gender(male vs female); ECOG PS(0 vs 1); ethnicity (Asian vs non-Asian), histology(intestinal vs diffuse), PD-L1 expression(≥ 1% vs < 1%). PD-L1 positivity was significantly associated with survival benefit from ICIs (HR: 0.82, p 0.047), with a significant interaction between PD-L1 expression and ICI efficacy (interaction HR: 1.41, p 0.02). Numerically, the second most relevant interaction was ICI efficacy and gender, with ICI being more effective in males.


CONCLUSION
The PD-L1 positive patient subgroup derives significant survival benefit from ICI in GOJ/GC, however other predictors are eagerly needed to further refine patient selection.
['Formica|V|V|', 'Morelli|C|C|', 'Patrikidou|A|A|', 'Shiu|K K|KK|', 'Nardecchia|A|A|', 'Lucchetti|J|J|', 'Roselli|M|M|', 'Arkenau|H T|HT|']
D000230:Adenocarcinoma D004943:Esophagogastric Junction D005260:Female D006801:Humans D000082082:Immune Checkpoint Inhibitors D008297:Male D061026:Programmed Cell Death 1 Receptor D013274:Stomach Neoplasms
Gastric adenocarcinoma Subgroup meta-analysis Gastro-oesophageal junction cancer Immune checkpoint inhibitors