Continuing immune checkpoint inhibitors beyond progression versus switching to non-ICI therapy in advanced gastric cancer: a real-world study - Report - MDSpire
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Continuing immune checkpoint inhibitors beyond progression versus switching to non-ICI therapy in advanced gastric cancer: a real-world study
Clinical Report: Efficacy of Continuing Immune Checkpoint Inhibitors in GC
Overview
This study evaluates the efficacy and safety of continuing immune checkpoint inhibitors (ICIs) after disease progression in advanced gastric cancer (GC) compared to switching to non-ICI treatments. Results indicate that continuing ICIs significantly improves both progression-free survival (PFS) and overall survival (OS).
Background
Advanced gastric cancer (GC) poses a significant global health challenge, with a low 5-year survival rate. The introduction of immune checkpoint inhibitors has transformed treatment options, yet the optimal second-line strategy post-progression remains unclear. This study addresses the critical gap in evidence regarding the continuation of ICIs versus non-ICI regimens after first-line therapy failure.
Data Highlights
Group
Median PFS (months)
Median OS (months)
CIBP
4.4
9.5
Non-CIBP
3.0
6.4
Key Findings
The CIBP group had a median PFS of 4.4 months compared to 3.0 months in the non-CIBP group (HR=0.47, p<0.001).
The median OS for the CIBP group was 9.5 months versus 6.4 months for the non-CIBP group (HR=0.51, p=0.0012).
Survival benefits of CIBP persisted after multivariable adjustments and propensity score matching.
Patients with PD-L1 expression ≥1% and those with a first-line PFS ≥6 months showed the greatest benefit from CIBP.
The safety profile of CIBP was manageable and comparable to non-CIBP treatments.
Clinical Implications
Continuing immune checkpoint inhibitors beyond progression may offer a viable second-line treatment strategy for selected patients with advanced gastric cancer. Clinicians should consider patient characteristics such as PD-L1 expression and prior treatment response when making therapeutic decisions.
Conclusion
Continuing ICIs after disease progression is associated with improved survival outcomes in advanced gastric cancer, suggesting a need for reevaluation of treatment strategies in this patient population.
