Changes in Chemotherapeutic Strategies and Their Prognostic Impact in Patients With Advanced Gastric Cancer

In Vivo. 2022 Jan-Feb;36(1):409-415. doi: 10.21873/invivo.12718.

Abstract

Background/aim: To investigate changes in post-progression chemotherapy (PPC) before and after nivolumab approval and determine their prognostic impact.

Patients and methods: A total of 146 patients with unresectable gastric cancer who had at least progressive disease after first- and/or second-line chemotherapy were retrospectively enrolled.

Results: Among the 146 patients, 46 and 23 received ramucirumab and nivolumab, respectively. Moreover, 95 and 62 patients received PPC after first- and second-line chemotherapy, respectively. Group B (i.e., at least chemotherapy after nivolumab approval) had significantly higher proportions of patients receiving ramucirumab therapy, nivolumab therapy, and PPC after first- or second-line chemotherapy compared to group A (i.e., termination of chemotherapy before nivolumab approval). Group A had significantly poorer prognosis than group B. Multivariate analysis showed that age, number of distant metastatic sites, and ramucirumab therapy were independent prognostic factors.

Conclusion: Changes in chemotherapeutic strategies, including PPC, might contribute to improved prognosis in patients with advanced gastric cancer.

Keywords: Post-progression chemotherapy; gastric cancer; nivolumab; prognosis; ramucirumab.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Humans
  • Nivolumab / adverse effects
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms* / drug therapy

Substances

  • Nivolumab