Does adding immunotherapy to neoadjuvant chemotherapy increase postoperative morbidity in gastroesophageal junction adenocarcinoma? A propensity score-matched study - Report - MDSpire
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Does adding immunotherapy to neoadjuvant chemotherapy increase postoperative morbidity in gastroesophageal junction adenocarcinoma? A propensity score-matched study
Clinical Report: Evaluating Neoadjuvant Immunotherapy in GEJ Adenocarcinoma
Overview
This study evaluates the postoperative morbidity associated with neoadjuvant immunotherapy combined with chemotherapy (NICT) versus neoadjuvant chemotherapy alone (NCT) in patients with gastroesophageal junction adenocarcinoma.
Background
Adenocarcinoma of the gastroesophageal junction (GEJ) has seen a rising incidence, presenting a significant health challenge. Current treatment strategies, including neoadjuvant chemotherapy, have improved survival rates, yet recurrence remains high. The integration of immunotherapy into neoadjuvant treatment regimens raises concerns regarding surgical safety and postoperative outcomes.
Data Highlights
Outcome
NICT (n=120)
NCT (n=120)
P-value
Major pathological regression
58.3%
45.8%
0.028
Major complications (Clavien-Dindo ≥III)
25.8%
22.5%
0.538
Anastomotic leak
11.7%
10.0%
-
Conduit failure
3.3%
2.5%
-
Pulmonary events
-
-
-
Immune-related adverse events
13.3%
-
-
Key Findings
NICT showed improved major pathological regression rates compared to NCT (58.3% vs. 45.8%; p=0.028).
No significant difference in major complications between NICT and NCT cohorts (25.8% vs. 22.5%; p=0.538).
Specific technical complications such as anastomotic leak and conduit failure were similar between groups.
Immune-related adverse events occurred in 13.3% of the NICT cohort without delaying surgical intervention.
NICT was not an independent predictor of morbidity according to multivariable analyses.
Clinical Implications
The findings suggest that the addition of immunotherapy to neoadjuvant chemotherapy does not significantly increase the risk of major postoperative complications in patients with GEJ adenocarcinoma. This information may assist in surgical planning and patient counseling regarding treatment options.
Conclusion
Further research through larger randomized trials is warranted.
