Akademik Veri Yönetim Sistemi
EURASIAN JOURNAL OF MEDICINE AND ONCOLOGY, cilt.8, sa.4, ss.488-495, 2024 (ESCI, TRDizin)
Objectives: Nivolumab immunotherapy, as well as ramucirumab with or without paclitaxel are treatment options as second line for advanced stage gastric cancer regardless of Programmed death-ligand 1 (PDL-1) status. These two tolerable treatments are not studied as combination in a phase 3 study, but phase 2. In our study, we aim to evaluate the real life data as efficacy and tolerability of this combination on gastric cancer patients. Methods: Retrospective data of the patients diagnosed with gastric adenocarcinoma whose having progressive metastatic disease after first-line systemic treatment at Koc University Hospital Medical Oncology Outpatient Clinic is evaluated. Immunotherapy in the first-line treatment was the exclusion criteria. Results: Patients’ median age was 47 years (min 24-max 83), and PDL-1 was ≥ 1% in 50% of patients. Progression-free and overall survival were 4.9 (95% CI: 0.0-10.3) and 10.9 months (95% CI: 6.1-15.8), respectively. Disease control rate and objective response rate were found to be 80% and 50%, respectively. PDL-1 status was not related to progression-free survival, overall survival, or response rate (p=0.66, 0.32 and 0.76, respectively). The regimen was generally tolerable with manageable side effects. The most common side effects were anemia, elevated liver enzymes and neutropenia. Conclusion: The combination of nivolumab along with paclitaxel and ramucirumab is a promising, effective and tolerable second line option for advanced gastric cancer. The regimen can be used irrespective of PDL-1 status, making immune checkpoints inhibitors an option for low immunogenic gastric tumors. Keywords: Antiangiogenic agents, gastric cancer, nivolumab, ramucirumab, immunotherapy