151P CO-STAR: Surgical conversion feasibility trial of sintilimab (PD-1 inhibitor) combined with doublet chemotherapy (Nab-PTX &amp; S-1) and apatinib (anti-angiogenic TKI) for the first-line treatment of stage IV gastric cancer (GC)

Qin, Xue; Wang, B.; Ding, Xiumin; Liu, Y.; Wang, X.; Liu, N.; Zhan, Hongjie; Ke, Bin; Li, B.; Cai, Mengxin; Deng, Jingyu; Wu, Lei; Huang, Wuhao; Liu, Hong; Sun, Yan; Liang, Han

doi:10.1016/j.annonc.2021.10.170

Annals of Oncology

2021

DOI: 10.1016/j.annonc.2021.10.170

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151P CO-STAR: Surgical conversion feasibility trial of sintilimab (PD-1 inhibitor) combined with doublet chemotherapy (Nab-PTX & S-1) and apatinib (anti-angiogenic TKI) for the first-line treatment of stage IV gastric cancer (GC)

Xue Qin

B. Wang

Xiumin Ding

et al.

Abstract: Volume 32 -Issue S7 -2021 S1445Conclusions: These results above showed this regimen was feasible and tolerable for surgical conversion of stage IV GC pts. Sintilimab, doublet chemotherapy, and apatinib might offer an opportunity of life-prolonging or cure for this population. Trial ID: NCT04267549.

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Clinical outcomes of conversion surgery following immune checkpoint inhibitors and chemotherapy in stage IV gastric cancer

Liang,

Yan,

et al. 2023

International Journal of Surgery

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Background: The clinical benefit of conversion surgery following immunochemotherapy in patients with stage IV gastric cancer (GC) remains uncertain. This study aims to clarify the clinical outcomes of conversion surgery for such patients. Methods: This retrospective cohort study enrolled consecutive patients with stage IV GC treated with a combination of immune checkpoint inhibitors (ICIs) and chemotherapy and/or anti-HER2 targeted therapy as first-line therapy. Cumulative survival curves were estimated using Kaplan-Meier method. Logistic regression and Cox regression analyses were conducted to identify factors associated with conversion surgery and survival, respectively. Results: Among the 136 patients included in the study. The disease control rate was 72.1% (98/136), with objective response rate in 58.8% (80/136) and complete response rate in 5.9% (8/136). Among 98 patients with disease control, 56 patients underwent palliative immunochemotherapy with median PFS and OS at 9.2 and 16.2 months, respectively; the remaining 42 patients underwent conversion surgery, yielding an unreached median PFS over a 19.0-month median follow-up, accompanied by one-year OS and PFS rates of 96.6% and 89.1%, respectively. The R0 resection rate reached 90.5% (38/42). 7 out of 42 patients achieved pathological complete response, of whom 3 patients demonstrated HER2 positivity. No serious complications leading to death were observed during the perioperative period. Multivariate analysis indicated that PD-L1 CPS ≥5 (odds ratio, 0.22; 95% CI, 0.08-0.57; P=0.002) favored successful conversion surgery, while signet ring cell carcinoma (hazard ratio, 6.29; 95% CI, 1.56–25.36; P=0.010) was the poor prognostic factor associated with survival in patients who underwent conversion surgery. Conclusions: Conversion surgery holds the potential for significant survival benefits in stage IV GC patients who have achieved a favorable clinical response to immunochemotherapy. Individuals with signet ring cell carcinoma may experience increased post-conversion surgery recurrence.

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Clinical outcomes of conversion surgery following immune checkpoint inhibitors and chemotherapy in stage IV gastric cancer

Liang,

Yan,

et al. 2023

International Journal of Surgery

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Oncological outcomes of sequential laparoscopic gastrectomy after treatment with camrelizumab combined with nab-paclitaxel plus S-1 for gastric cancer with serosal invasion

Lin,

Lin

et al. 2024

Front. Immunol.

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ObjectiveTo explore the oncological outcomes of sequential laparoscopic gastrectomy after treatment with camrelizumab in combination with nab-paclitaxel plus S-1 for the treatment of gastric cancer with serosal invasion.MethodsThis study is a retrospective cohort study and retrospectively analyzed the clinicopathological data of 128 patients with serosal invasion gastric cancer (cT4NxM0) who received nab-paclitaxel + S-1(SAP) or camrelizumab + nab-paclitaxel + S-1 (C-SAP) regimen and underwent laparoscopy assisted gastrectomy in Fujian Union Hospital from March 2019 to December 2020. The patients were divided into SAP group and C-SAP group. The 2-years overall survival rate, 2-year recurrence free survival rate recurrence rate and initial recurrence time were compared between the two groups.ResultsA total of 128 patients were included, including 90 cases in SAP group and 38 cases in C-SAP group. There were no significant differences in age, gender, gastrectomy method, surgical approach, R0 resection, nerve invasion, vascular invasion, total number of harvested lymph nodes, number of positive lymph nodes and major pathologic response (MPR) rate between the two groups (P>0.05). However, the proportion of ypT0, ypN0 and pCR rate in C-SAP group were significantly higher than those in SAP group (P<0.05). The 2-year OS of C-SAP group (80.7%) was higher than that of SAP group (67.8%), and the difference was not statistically significant (P = 0.112); At 2 years after operation, the recurrence rate of C-SAP group (44.3%) was lower than that of SAP group (55.8%) (P = 0.097); Further analysis showed that the average time to recurrence in the C-SAP group was 18.9 months, which was longer than that in SAP group 13.1 months (P = 0.004); The 2-year recurrence free survival rate in C-SAP group was higher than that in SAP group (P=0.076); There was no significant difference in the overall survival time after recurrence between the two groups (P= 0.097).ConclusionCamrelizumab combined with neoadjuvant chemotherapy can improve the proportion of ypT0, ypN0 and pCR in patients, while prolonging the initial recurrence time of patients in the C-SAP group, but did not increase the immunotherapy/chemotherapy related side effects and postoperative complications.

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151P CO-STAR: Surgical conversion feasibility trial of sintilimab (PD-1 inhibitor) combined with doublet chemotherapy (Nab-PTX & S-1) and apatinib (anti-angiogenic TKI) for the first-line treatment of stage IV gastric cancer (GC)

Cited by 2 publications

References 0 publications

Clinical outcomes of conversion surgery following immune checkpoint inhibitors and chemotherapy in stage IV gastric cancer

Clinical outcomes of conversion surgery following immune checkpoint inhibitors and chemotherapy in stage IV gastric cancer

Oncological outcomes of sequential laparoscopic gastrectomy after treatment with camrelizumab combined with nab-paclitaxel plus S-1 for gastric cancer with serosal invasion

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