Systemic therapy for gastric cancer: Perioperative strategies and beyond

Cann, Christopher; Ciombor, Kristen K.

doi:10.1002/jso.26834

Cited by 11 publications

(9 citation statements)

References 56 publications

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“…In addition to genetic factors, the incidence of GC can also be attributed to various pathogenic infections, resulting in high morbidity and mortality ( 33 , 34 ). Despite the progress made in multimodal therapy for GC, recurrence of the disease is still common ( 35 ). Furthermore, owing to the absence of early diagnostic markers, GC is frequently diagnosed in its advanced stages, significantly diminishing the likelihood of survival, dependable biomarkers are critically necessary to facilitate early detection and survival forecasting.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Zhang

Qiu

et al. 2023

Front. Oncol.

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BackgroundThe neutrophil to lymphocyte ratio (NLR) is a cost-effective and easily identifiable inflammatory biomarker that has been shown to be closely associated with tumor prognosis and predict survival in patients with multiple malignancies. However, the predictive value of NLR in patients with gastric cancer (GC) treated with immune checkpoint inhibitors (ICIs) has not been fully explored. Therefore, we conducted a meta-analysis to explore the potential of NLR as a predictor of survival in this population.MethodsWe systematically searched the PubMed, Cochrane Library, and EMBASE databases from inception to the present for observational researches on NLR and its relationship with progression or survival in GC patients receiving ICIs. To assess the prognostic significance of NLR on overall survival (OS) or progression-free survival (PFS), we used fixed or random-effect models to derive and combine hazard ratios (HRs) with 95% confidence intervals (CIs). We also examined the relationship between NLR and treatment efficacy by calculating relative risks (RRs) with 95% CIs for objective response rate (ORR) and disease control rate (DCR) in patients with GC receiving ICIs.ResultsNine studies of 806 patients were eligible. OS and PFS data were obtained from 9 and 5 studies, respectively. In nine studies, NLR was associated with poor survival, the pooled HR was 1.98 (95% CI 1.67- 2.35, p < 0.001), indicating a significant association between high NLR and worse OS. We conducted subgroup analyses based on study characteristics to confirm the robustness of our findings. A relationship between NLR and PFS were reported in five studies with a HR of 1.49 (95% CI 0.99- 2.23, p = 0.056), which was not significantly associated. Pooling four studies that examined the correlation between NLR and ORR/DCR in GC patients, we observed a significant correlation between NLR and ORR (RR = 0.51, p = 0.003), but no significant correlation between NLR and DCR (RR = 0.48, p = 0.111).ConclusionIn summary, this meta-analysis indicates that increased NLR is significantly linked to worse OS in patients with GC receiving ICIs. In addition, lowering NLR can improve ORR. Thus, NLR can serve as a predictor for prognosis and treatment response in GC patients treated with ICIs. Nevertheless, further high-quality prospective studies are required to verify our findings in the future.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Zhang

Qiu

et al. 2023

Front. Oncol.

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“…The pivotal randomized controlled clinical trials of perioperative (neoadjuvant) and adjuvant therapy for GC are listed in Table 4 . Adjuvant (postoperative) systemic chemotherapy is typically used in Asian countries because D2 lymph node dissection is routinely performed in advanced GC [ 78 ]; perioperative chemotherapy (neoadjuvant plus adjuvant therapy) is mainly used in European countries [ 79 ], and adjuvant chemoradiation is historically preferred in North America [ 80 ]. These marked disparities between the East and West are attributable to surgical procedures and their outcomes, which result in considerable geographical variation in the preferred adjuvant treatment for localized GC [ 81 , 82 ].…”

Section: Adjuvant Therapy For Gastric Cancermentioning

confidence: 99%

Overview of Chemotherapy for Gastric Cancer

Sato

Okamoto

Kida

et al. 2023

JCM

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Gastric cancer (GC) is one of the most clinically challenging cancers worldwide. Over the past few years, new molecular-targeted agents and immunotherapy have markedly improved GC prognosis. Human epidermal growth factor receptor 2 (HER2) expression is a key biomarker in first-line chemotherapy for unresectable advanced GC. Further, the addition of trastuzumab to cytotoxic chemotherapy has extended the overall survival of patients with HER2-positive advanced GC. In HER2-negative GC, the combination of nivolumab, an immune checkpoint inhibitor, and a cytotoxic agent has been demonstrated to prolong the overall survival of GC patients. Ramucirumab and trifluridine/tipiracil, which are second- and third-line treatments for GC, and trastuzumab deruxtecan, an antibody–drug conjugate for HER2-positive GC, have been introduced in clinics. New promising molecular-targeted agents are also being developed, and combination therapy comprising immunotherapy and molecular-targeted agents is expected. As the number of available drugs increases, it is important to understand the target biomarkers and drug characteristics and select the optimal therapy for each patient. For resectable disease, differences in the extent of standard lymphadenectomy between Eastern and Western countries have led to different standard treatments: perioperative (neoadjuvant) and adjuvant therapy. This review aimed to summarize recent advances in chemotherapy for advanced GC.

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“…Chemotherapy, targeted therapy, and immunotherapy are needed in advanced GC as they are able to provide some therapeutic effects ( 77 ). However, they inevitably result in drug resistance in the course of treatment, which will lead to a significant decline in treatment efficacy.…”

Section: Conclusion and Future Perspectivementioning

confidence: 99%

CircRNA: A new class of targets for gastric cancer drug resistance therapy

Zheng

Wang

et al. 2023

Pathol. Oncol. Res.

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Gastric cancer (GC) is one of the most common malignancies worldwide. Patients with advanced GC need palliative care to ensure survival. This includes the use of chemotherapy agents, such as cisplatin, 5-fluorouracil, oxaliplatin, paclitaxel, and pemetrexed, as well as targeted agents. However, the emergence of drug resistance evidence in poor patient outcomes and poor prognosis is a motivation to determine the specific mechanism of drug resistance. Interestingly, circular RNAs (circRNAs) play an important part in the carcinogenesis and progression of GC and are involved in GC drug resistance. This review systematically summarizes the functions and mechanisms of circRNAs underlying GC drug resistance, especially chemoresistance. It also emphasizes that circRNAs can serve as promising targets for improving drug resistance and therapeutic efficacy.

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Systemic therapy for gastric cancer: Perioperative strategies and beyond

Cited by 11 publications

References 56 publications

Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Overview of Chemotherapy for Gastric Cancer

CircRNA: A new class of targets for gastric cancer drug resistance therapy

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