Continuing immune checkpoint inhibitors beyond progression versus switching to non-ICI therapy in advanced gastric cancer: a real-world study

Category	Detail
Condition	Advanced Gastric/Gastroesophageal Junction Cancer
Key Mechanisms	Immune checkpoint inhibitors targeting PD-1/PD-L1 pathways to reinvigorate anti-tumor immunity.
Target Population	Patients with advanced GC/GEJC who progressed after first-line ICI plus chemotherapy.
Care Setting	Single-center, real-world retrospective study.

CIBP group showed improved median PFS (4.4 months) compared to non-CIBP group (3.0 months).
CIBP group had a median OS of 9.5 months versus 6.4 months in the non-CIBP group.
Survival benefits of CIBP were consistent after multivariable adjustment and propensity score matching.
Subgroup analyses indicated greater benefits for patients with PD-L1 expression ≥1% and those with first-line PFS ≥6 months.
Safety profiles were manageable and comparable between both treatment groups.

Consider continuing immune checkpoint inhibitors beyond progression (CIBP) for selected patients.

Monitor progression-free survival (PFS) and overall survival (OS) as primary endpoints.

Exclusion criteria include treatment intolerance, severe autoimmune diseases, and incomplete clinical data.

169 patients with advanced GC/GEJC who progressed after first-line ICI plus chemotherapy.

CIBP may be a valid second-line strategy for selected patients following first-line immuno-chemotherapy failure.

Incorporate ICI-based combinations with chemotherapy or other systemic therapies for CIBP.
Evaluate PD-L1 expression and first-line PFS to identify potential beneficiaries of CIBP.

Clinical Scorecard: Evaluating the Efficacy of Continuing Immune Checkpoint Inhibitors After Disease Progression Versus Transitioning to Non-ICI Treatments in Advanced Gastric Cancer: A Real-World Analysis