Author:
Wang Jincheng,Lin Jie,Wang Ruimin,Tong Ti,Zhao Yinghao
Abstract
Abstract
Background
Immunotherapy or apatinib alone has been used as third-line adjuvant therapy for advanced or metastatic gastric/gastroesophageal junction (G/GEJ) tumors, but the efficacy of combining them with each other for the treatment of patients with advanced or metastatic G/GEJ is unknown; therefore, we further evaluated the efficacy and safety of immunotherapy combined with apatinib in patients with advanced or metastatic G/GEJ.
Methods
The main search was conducted on published databases: Embase, Cochrane library, PubMed.The search was conducted from the establishment of the database to December 2023.Clinical trials with patients with advanced or metastatic G/GEJ and immunotherapy combined with apatinib as the study variable were collected. Review Manager 5.4 software as well as stata 15.0 software were used for meta-analysis.
Results
A total of 651 patients from 19 articles were included in this meta-analysis. In the included studies, immunotherapy combined with apatinib had a complete response (CR) of 0.03 (95% CI: 0.00 -0.06), partial response (PR) of 0.34 (95% CI: 0.19–0.49), stable disease (SD) of 0.43 (95% CI: 0.32–0.55), objective response rate (ORR) was 0.36 (95% CI: 0.23–0.48), disease control rate (DCR) was 0.80 (95% CI: 0.74–0.86), and median progression-free survival (PFS) was 4.29 (95% CI: 4.05–4.52), median Overall survival (OS) was 8.79 (95% CI: 7.92–9.66), and the incidence of grade ≥ 3 TRAEs was 0.34 (95% CI: 0:19-0.49). PR, ORR, DCR, median PFS and median OS were significantly higher in the immunotherapy and apatinib combination chemotherapy group (IAC) than in the immunotherapy combination apatinib group (IA). And the difference was not significant in the incidence of SD and grade ≥ 3 TRAEs.
Conclusion
This meta-analysis shows that immunotherapy combined with apatinib is safe and effective in the treatment of advanced or metastatic G/GEJ, where IAC can be a recommended adjuvant treatment option for patients with advanced or metastatic G/GEJ. However, more large multicenter randomized studies are urgently needed to reveal the long-term outcomes of immunotherapy combined with apatinib treatment.
Funder
Jilin Provincial Education Department
The Health and Medicine Special Fund of Jilin Provincial Science and Technology Department
Chinese Society Of Clinical Oncology
Health Commission of Jilin Province
Publisher
Springer Science and Business Media LLC
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