Immunotherapy or Targeted Therapy Versus Best Supportive Care for Advanced Gastric Cancer : A Systematic Review and Meta-analysis of Randomized Trials
Meade, Adriana-Gabriela (Institut de Recerca Sant Pau)
Santero, Marilina (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Savall-Esteve, Olga (Institut de Recerca Sant Pau)
Pérez Bracchiglione, Javier Andrés (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Leache, Leire (Instituto de Investigación Sanitaria de Navarra)
Selva, Anna (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Macias Declara, Ismael (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Cerdà, Paula (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Bonfill, X. (Xavier) (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)

Date:	2025
Abstract:	Purpose: To assess the efficacy and safety of non-chemotherapy anticancer drugs (immunotherapy or targeted therapy) compared to best supportive care (BSC) or placebo for the treatment of advanced gastric cancer (GC). Methods: Systematic review of randomized controlled trials (RCTs) searching (May 2022) MEDLINE, EMBASE, CENTRAL, Epistemonikos, ClinicalTrials. gov, and PROSPERO. Certainty of evidence was evaluated following GRADE. Results: Six RCTs included. Targeted therapies likely result in a slight increase in overall survival (OS) (HR 0. 84, 95% CI 0. 75, 0. 93; moderate certainty) and progression-free survival (PFS) (HR 0. 52, 95% CI 0. 43, 0. 62; moderate certainty). Toxicity had a slightly increased risk (RR 1. 19, 95% CI 0. 95, 1. 48; low certainty). Immunotherapy also showed a likely improvement in PFS (HR 0. 60, 95% CI 0. 49, 0. 73; moderate certainty), while toxicity showed a likely higher risk (RR 2. 72, 95% CI 1. 24, 5. 94; moderate certainty). However, benefits in survival translated to time gains of slightly over a month for OS and less than a month for PFS. No data were reported on performance status (PS), hospital admissions, or quality of life (QoL). Conclusions: Our study suggests some survival benefits with low toxicity from these treatments, but gains are marginal. Uncertainties persist regarding their impact on QoL and outcomes for patients with poor PS. Caution is advised in treatment selection for advanced GC patients, who should actively participate in decision-making. Future research should include diverse patient populations and assess patient-centered outcomes with consistent comparator groups for BSC. Trial Registration: The study protocol was registered in OSF (https://doi. org/10. 17605/OSF. IO/7CHX6) on 2022-04-01.
Grants:	Instituto de Salud Carlos III PI18/00034
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Advanced gastric cancer ; Immunotherapy ; Targeted therapy ; Systematic review ; Meta-analysis ; Nonchemotherapy anticancer drugs
Published in:	Journal of gastrointestinal cancer, Vol. 56, Núm. 1 (March 2025) (Articles) , ISSN 1941-6636

DOI: 10.1007/s12029-024-01155-y
PMID: 40032744

13 p, 1.1 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles