Immune checkpoint inhibitors for treatment of advanced gastric or gastroesophageal junction cancer: Current evidence and future perspectives

Zhening Zhang; Tong Xie; Xiaotian Zhang; Changsong Qi; Lin Shen; Zhi Peng

doi:10.21147/j.issn.1000-9604.2020.03.02

Immune checkpoint inhibitors for treatment of advanced gastric or gastroesophageal junction cancer: Current evidence and future perspectives

Chin J Cancer Res. 2020 Jun;32(3):287-302. doi: 10.21147/j.issn.1000-9604.2020.03.02.

Authors

Zhening Zhang¹, Tong Xie¹, Xiaotian Zhang¹, Changsong Qi¹, Lin Shen¹, Zhi Peng¹

Affiliation

¹ Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China.

PMID: 32694895
PMCID: PMC7369180
DOI: 10.21147/j.issn.1000-9604.2020.03.02

Abstract

Despite the application of conventional therapies, the prognosis of advanced gastric cancer (GC) or gastroesophageal junction cancer (GEJC) is still poor. In recent years, immune checkpoint inhibitors (ICIs) have reshaped the paradigm of cancer therapy. Emerging evidence support the feasibility of programmed cell death-1 (PD-1) and its ligand (PD-L1) inhibition in chemo-refractory GC/GEJC. Nivolumab and pembrolizumab have initially been approved in Japan and United States, respectively for the third-line treatment of progressive GC or GEJC. In March 2020, nivolumab has also been licensed in China for treating advanced GC/GEJC who received ≥2 lines of systemic therapies. Current studies are moving forward to the first-line application or focusing on combination strategies, though data are insufficient and disputable. In this review, we summarize the recently reported and ongoing clinical trials in ICIs for advanced GC/GEJC. Molecular characteristics and clinical implications of different tumor subtypes are also reviewed. We further discuss the safety profile and biomarkers for predicting the response of ICIs, which has guiding values in clinical practice.

Keywords: Biomarker; gastric cancer; gastroesophageal junction cancer; immune checkpoint inhibitors; immunotherapy; safety.