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ISSN (Print): 0929-8673
ISSN (Online): 1875-533X

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Meta-Analysis

Efficacy of Chemoimmunotherapy versus Chemotherapy for Gastric Cancer: A Meta-Analysis of Survival Outcomes

Author(s): Juan Xie, Lin Chen, Qing Liu, Xi-Tai Li and Xiao-Yong Lei*

Volume 31, Issue 18, 2024

Published on: 23 January, 2024

Page: [2649 - 2660] Pages: 12

DOI: 10.2174/0109298673263335231121103807

Price: $65

Abstract

Background: Gastric cancer has been traditionally treated with chemotherapy as the primary mode of treatment. However, recent studies have shown that chemoimmunotherapy is also effective and, in some cases, better than chemotherapy treatment. Current study aimed to find the efficacy of chemoimmunotherapy versus chemotherapy in the treatment of gastric cancer.

Methods: Using electronic databases, including PubMed, Embase, and EBSCO, a thorough literature search was carried out for the years 2006 to 2023. The search strategy was designed to identify relevant studies based on chemoimmunotherapy and chemotherapy intervention, and the search was conducted using appropriate keywords and MeSH terms. The retrieved studies were screened for relevance based on their titles, abstracts, and full texts. The studies' inclusion criteria were predefined, and the selected studies were then subjected to a quality assessment using GradePro GDT. The data from selected studies were extracted and analyzed using Revman version 5.4.

Results: The study found that chemoimmunotherapy treatment resulted in a significant improvement in overall survival (OS) with a risk ratio (RR) of 1.54 and a 95% Confidence Interval (CI) of 1.25 to 1.89. The overall effect was also found to be significant, with a p-value of less than 0.001. Furthermore, we also observed an improvement in the 1-year, 3-year, and 5-year survival rates with risk ratio (RR) of 1.09 (95% CI: 1.01, 1.17), 1.43 (95% CI: 1.28, 1.60), and 1.59 (95% CI: 1.10, 2.30), respectively. In addition, it’s also found that chemoimmunotherapy treatment also resulted in an improvement in DFS with an RR of 1.94 and a 95% CI of 1.44 to 2.59. Overall, these results suggest that chemoimmunotherapy treatment can be an effective approach in comparison to chemotherapy for improving overall survival and disease-free survival in the studied population.

Conclusion: This study comparing chemoimmunotherapy versus chemotherapy for gastric cancer showed that both treatments were effective, but chemoimmunotherapy had more significant efficacy. To support these results, additional studies with a large sample size and a longer follow-up time are required.

Keywords: Gastric cancer, chemotherapy, immunotherapy, overall survival, disease-free survival, dendritic cell.

« Previous
[1]
Wong, M.C.S.; Huang, J.; Chan, P.S.F.; Choi, P.; Lao, X.Q.; Chan, S.M.; Teoh, A.; Liang, P. Global incidence and mortality of gastric cancer, 1980-2018. JAMA Netw. Open, 2021, 4(7), e2118457.
[http://dx.doi.org/10.1001/jamanetworkopen.2021.18457] [PMID: 34309666]
[2]
Sung, H.; Ferlay, J.; Siegel, R.L.; Laversanne, M.; Soerjomataram, I.; Jemal, A.; Bray, F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin., 2021, 71(3), 209-249.
[http://dx.doi.org/10.3322/caac.21660] [PMID: 33538338]
[3]
Dolcetti, R.; De Re, V.; Canzonieri, V. Immunotherapy for gastric cancer: Time for a personalized approach? Int. J. Mol. Sci., 2018, 19(6), 1602.
[http://dx.doi.org/10.3390/ijms19061602] [PMID: 29844297]
[4]
Takei, S.; Kawazoe, A.; Shitara, K. The new era of immunotherapy in gastric cancer. Cancers, 2022, 14(4), 1054.
[http://dx.doi.org/10.3390/cancers14041054] [PMID: 35205802]
[5]
Mu, W.; Chu, Q.; Liu, Y.; Zhang, N. A review on nano-based drug delivery system for cancer chemoimmunotherapy. Nano-Micro Lett., 2020, 12(1), 142.
[http://dx.doi.org/10.1007/s40820-020-00482-6] [PMID: 34138136]
[6]
Salas-Benito, D.; Pérez-Gracia, J.L.; Ponz-Sarvisé, M.; Rodriguez-Ruiz, M.E.; Martínez-Forero, I.; Castañón, E.; López-Picazo, J.M.; Sanmamed, M.F.; Melero, I. Paradigms on immunotherapy combinations with chemotherapy. Cancer Discov., 2021, 11(6), 1353-1367.
[http://dx.doi.org/10.1158/2159-8290.CD-20-1312] [PMID: 33712487]
[7]
Jiang, H.; Wang, J.; Deng, W. Pathologic complete response to chemoimmunotherapy of an advanced gastric cancer patient with high PD-L1 expression, dMMR, and unique gut microbiota composition: A case report. Front. Oncol., 2023, 13, 1150931.
[http://dx.doi.org/10.3389/fonc.2023.1150931] [PMID: 37007083]
[8]
Garofano, F.; Gonzalez-Carmona, M.A.; Skowasch, D.; Schmidt-Wolf, R.; Abramian, A.; Hauser, S.; Strassburg, C.P.; Schmidt-Wolf, I.G.H. Clinical trials with combination of cytokine-induced killer cells and dendritic cells for cancer therapy. Int. J. Mol. Sci., 2019, 20(17), 4307.
[http://dx.doi.org/10.3390/ijms20174307] [PMID: 31484350]
[9]
Wang, S.; Wang, X.; Zhou, X.; Lyerly, H.K.; Morse, M.A.; Ren, J. DC-CIK as a widely applicable cancer immunotherapy. Expert Opin. Biol. Ther., 2020, 20(6), 601-607.
[http://dx.doi.org/10.1080/14712598.2020.1728250] [PMID: 32033522]
[10]
Murugan, D.; Murugesan, V.; Panchapakesan, B.; Rangasamy, L. Nanoparticle enhancement of Natural Killer (NK) cell-based immunotherapy. Cancers, 2022, 14(21), 5438.
[http://dx.doi.org/10.3390/cancers14215438] [PMID: 36358857]
[11]
Sharma, A.; Schmidt-Wolf, I.G.H. 30 years of CIK cell therapy: recapitulating the key breakthroughs and future perspective. J. Exp. Clin. Cancer Res., 2021, 40(1), 388.
[http://dx.doi.org/10.1186/s13046-021-02184-2] [PMID: 34886895]
[12]
Zhang, X.; Yang, J.; Zhang, G.; Lu, P.A. 11-Year clinical summary of DC - CIK / NK cell immunotherapy for 152 patients with acute myeloid leukemia. Blood, 2017, 130(Suppl. 1), 1369-69.
[http://dx.doi.org/10.1182/blood.V130.Suppl_1.1369.1369]
[13]
Joshi, S.S.; Badgwell, B.D. Current treatment and recent progress in gastric cancer. CA Cancer J. Clin., 2021, 71(3), 264-279.
[http://dx.doi.org/10.3322/caac.21657] [PMID: 33592120]
[14]
Esfahani, K.; Roudaia, L.; Buhlaiga, N.; Del Rincon, S.V.; Papneja, N.; Miller, W.H., Jr A review of cancer immunotherapy: from the past, to the present, to the future. Curr. Oncol., 2020, 27(12)(Suppl. 2), 87-97.
[http://dx.doi.org/10.3747/co.27.5223] [PMID: 32368178]
[15]
Xie, T.; Zhang, Z.; Zhang, X.; Qi, C.; Shen, L.; Peng, Z. Appropriate PD-L1 cutoff value for gastric cancer immunotherapy: A systematic review and meta-analysis. Front. Oncol., 2021, 11, 646355.
[http://dx.doi.org/10.3389/fonc.2021.646355] [PMID: 34540656]
[16]
Liberati, A.; Altman, D.G.; Tetzlaff, J.; Mulrow, C.; Gøtzsche, P.C.; Ioannidis, J.P.A.; Clarke, M.; Devereaux, P.J.; Kleijnen, J.; Moher, D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med., 2009, 6(7), e1000100.
[http://dx.doi.org/10.1371/journal.pmed.1000100] [PMID: 19621070]
[17]
Schünemann, H.J.; Best, D.; Vist, G.; Oxman, A.D.; Group, G.W. Letters, numbers, symbols and words: How to communicate grades of evidence and recommendations. CMAJ, 2003, 169(7), 677-680.
[PMID: 14517128]
[18]
GRADEpro GDT. GRADEpro GDT: GRADEpro guideline development tool. McMaster University and Evidence Prime 2022. Available from: gradepro.org
[19]
Liu, G.; Chen, D.; Zhao, X.; You, X.; Huang, C.; Cheng, Z.; Mao, X.; Zhou, H. Efficacy of DC-CIK immunotherapy combined with chemotherapy on locally advanced gastric cancer. J. Oncol., 2022, 2022, 1-6.
[http://dx.doi.org/10.1155/2022/5473292] [PMID: 35865086]
[20]
Knödler, M.; Körfer, J.; Kunzmann, V.; Trojan, J.; Daum, S.; Schenk, M.; Kullmann, F.; Schroll, S.; Behringer, D.; Stahl, M.; Al-Batran, S.E.; Hacker, U.; Ibach, S.; Lindhofer, H.; Lordick, F. Randomised phase II trial to investigate catumaxomab (anti-EpCAM × anti-CD3) for treatment of peritoneal carcinomatosis in patients with gastric cancer. Br. J. Cancer, 2018, 119(3), 296-302.
[http://dx.doi.org/10.1038/s41416-018-0150-6] [PMID: 29988111]
[21]
Sahin, U.; Türeci, Ö.; Manikhas, G.; Lordick, F.; Rusyn, A.; Vynnychenko, I.; Dudov, A.; Bazin, I.; Bondarenko, I.; Melichar, B.; Dhaene, K.; Wiechen, K.; Huber, C.; Maurus, D.; Arozullah, A.; Park, J.W.; Schuler, M.; Al-Batran, S.E. FAST: a randomised phase II study of zolbetuximab (IMAB362) plus EOX versus EOX alone for first-line treatment of advanced CLDN18.2-positive gastric and gastro-oesophageal adenocarcinoma. Ann. Oncol., 2021, 32(5), 609-619.
[http://dx.doi.org/10.1016/j.annonc.2021.02.005] [PMID: 33610734]
[22]
Malka, D.; François, E.; Penault-Llorca, F.; Castan, F.; Bouché, O.; Bennouna, J.; Ghiringhelli, F.; de la Fouchardière, C.; Borg, C.; Samalin, E.; Bachet, J.B.; Raoul, J.L.; Miglianico, L.; Bengrine-Lefèvre, L.; Dahan, L.; Lecaille, C.; Aparicio, T.; Stanbury, T.; Perrier, H.; Cayre, A.; Laurent-Puig, P.; Gourgou, S.; Emile, J.F.; Taïeb, J. FOLFOX alone or combined with rilotumumab or panitumumab as first-line treatment for patients with advanced gastroesophageal adenocarcinoma (PRODIGE 17-ACCORD 20-MEGA): A randomised, open-label, three-arm phase II trial. Eur. J. Cancer, 2019, 115, 97-106.
[http://dx.doi.org/10.1016/j.ejca.2019.04.020] [PMID: 31129386]
[23]
Liu, T.; Bai, Y.; Lin, X.; Li, W.; Wang, J.; Zhang, X.; Pan, H.; Bai, C.; Bai, L.; Cheng, Y.; Zhang, J.; Zhong, H.; Ba, Y.; Hu, W.; Xu, R.; Guo, W.; Qin, S.; Yang, N.; Lu, J.; Shitara, K.; Lei, M.; Li, M.; Bao, N.; Chen, T.; Shen, L. First- line nivolumab plus chemotherapy vs. chemotherapy in patients with advanced gastric, gastroesophageal junction and esophageal adenocarcinoma: CHECKMATE 649 Chinese subgroup analysis. Int. J. Cancer, 2023, 152(4), 749-760.
[http://dx.doi.org/10.1002/ijc.34296] [PMID: 36121651]
[24]
Li, Y.; Wang, C.; Xu, M.; Kong, C.; Qu, A.; Zhang, M.; Zheng, Z.; Zhang, G. Preoperative NLR for predicting survival rate after radical resection combined with adjuvant immunotherapy with CIK and postoperative chemotherapy in gastric cancer. J. Cancer Res. Clin. Oncol., 2017, 143(5), 861-871.
[http://dx.doi.org/10.1007/s00432-016-2330-1] [PMID: 28108815]
[25]
Wang, Y.; Wang, C.; Xiao, H.; Niu, C.; Wu, H.; Jin, H.; Yao, C.; He, H.; Tian, H.; Han, F.; Li, D.; Han, W.; Xu, J.; Chen, J.; Cui, J.; Li, W. Adjuvant treatment combining cellular immunotherapy with chemotherapy improves the clinical outcome of patients with stage II/III gastric cancer. Cancer Med., 2017, 6(1), 45-53.
[http://dx.doi.org/10.1002/cam4.942] [PMID: 27790867]
[26]
Zhou, C.; Wang, W.; Xie, J.; Zhang, Y.; Yang, Y.; Mu, Y. Efficacy and safety of cord blood-derived dendritic cells plus cytokine-induced killer cells combined with chemotherapy in the treatment of patients with advanced gastric cancer: A randomized Phase II study. OncoTargets Ther., 2016, 9, 4617-4627.
[http://dx.doi.org/10.2147/OTT.S107745] [PMID: 27524915]
[27]
Chen, Y.; Guo, Z.Q.; Shi, C.M.; Zhou, Z.F.; Ye, Y.B.; Chen, Q. Efficacy of adjuvant chemotherapy combined with immunotherapy with cytokine-induced killer cells for gastric cancer after d2 gastrectomy. Int. J. Clin. Exp. Med., 2015, 8(5), 7728-7736.
[PMID: 26221323]
[28]
Gao, D.; Li, C.; Xie, X.; Zhao, P.; Wei, X.; Sun, W.; Liu, H.C.; Alexandrou, A.T.; Jones, J.; Zhao, R.; Li, J.J. Autologous tumor lysate-pulsed dendritic cell immunotherapy with cytokine-induced killer cells improves survival in gastric and colorectal cancer patients. PLoS One, 2014, 9(4), e93886.
[http://dx.doi.org/10.1371/journal.pone.0093886] [PMID: 24699863]
[29]
Liu, H.; Song, J.; Yang, Z.; Zhang, X. Effects of cytokine-induced killer cell treatment combined with FOLFOX4 on the recurrence and survival rates for gastric cancer following surgery. Exp. Ther. Med., 2013, 6(4), 953-956.
[http://dx.doi.org/10.3892/etm.2013.1247] [PMID: 24137296]
[30]
Zhao, H.; Fan, Y.; Li, H.; Yu, J.; Liu, L.; Cao, S.; Ren, B.; Yan, F.; Ren, X. Immunotherapy with cytokine-induced killer cells as an adjuvant treatment for advanced gastric carcinoma: A retrospective study of 165 patients. Cancer Biother. Radiopharm., 2013, 28(4), 303-309.
[http://dx.doi.org/10.1089/cbr.2012.1306] [PMID: 23506427]
[31]
Shi, L.; Zhou, Q.; Wu, J.; Ji, M.; Li, G.; Jiang, J.; Wu, C. Efficacy of adjuvant immunotherapy with cytokine-induced killer cells in patients with locally advanced gastric cancer. Cancer Immunol. Immunother., 2012, 61(12), 2251-2259.
[http://dx.doi.org/10.1007/s00262-012-1289-2] [PMID: 22674056]
[32]
Jiang, J.T.; Shen, Y.P.; Wu, C.P.; Zhu, Y.B.; Wei, W.X.; Chen, L.J.; Zheng, X.; Sun, J.; Lu, B.F.; Zhang, X.G. Increasing the frequency of CIK cells adoptive immunotherapy may decrease risk of death in gastric cancer patients. World J. Gastroenterol., 2010, 16(48), 6155-6162.
[http://dx.doi.org/10.3748/wjg.v16.i48.6155] [PMID: 21182234]
[33]
Jiang, J.; Xu, N.; Wu, C.; Deng, H.; Lu, M.; Li, M.; Xu, B.; Wu, J.; Wang, R.; Xu, J.; Nilsson-Ehle, P. Treatment of advanced gastric cancer by chemotherapy combined with autologous cytokine-induced killer cells. Anticancer Res., 2006, 26(3B), 2237-2242.
[PMID: 16821594]
[34]
Sumer, F.; Gundogan, E.; Kaplan, K.; Okut, G.; Kayaalp, C. Transvaginal specimen extraction after laparoscopic gastrectomy for tumors. Surg. Laparosc. Endosc. Percutan. Tech., 2022, 32(2), 247-251.
[http://dx.doi.org/10.1097/SLE.0000000000001031] [PMID: 34966150]
[35]
Hashimoto, I.; Oshima, T. Claudins and gastric cancer: An overview. Cancers, 2022, 14(2), 290.
[http://dx.doi.org/10.3390/cancers14020290] [PMID: 35053454]
[36]
Lee, J.L.; Kang, Y.K. Capecitabine in the treatment of advanced gastric cancer. Future Oncol., 2008, 4(2), 179-198.
[http://dx.doi.org/10.2217/14796694.4.2.179] [PMID: 18407732]
[37]
Huynh, J.; Patel, K.; Gong, J.; Cho, M.; Malla, M.; Parikh, A.; Klempner, S. Immunotherapy in gastroesophageal cancers: Current evidence and ongoing trials. Curr. Treat. Options Oncol., 2021, 22(11), 100.
[http://dx.doi.org/10.1007/s11864-021-00893-6] [PMID: 34524553]
[38]
Högner, A.; Moehler, M. Immunotherapy in gastric cancer. Curr. Oncol., 2022, 29(3), 1559-1574.
[http://dx.doi.org/10.3390/curroncol29030131] [PMID: 35323331]
[39]
Zhang, L.; Mu, Y.; Zhang, A.; Xie, J.; Chen, S.; Xu, F.; Wang, W.; Zhang, Y.; Ren, S.; Zhou, C. Cytokine-induced killer cells/dendritic cells-cytokine induced killer cells immunotherapy combined with chemotherapy for treatment of colorectal cancer in China: a meta-analysis of 29 trials involving 2,610 patients. Oncotarget, 2017, 8(28), 45164-45177.
[http://dx.doi.org/10.18632/oncotarget.16665] [PMID: 28404886]

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