A multicenter retrospective study of PD-1 blockade plus chemotherapy as first-line therapy in advanced hepatoid adenocarcinoma of the stomach

TL;DR

A study finds that combining PD-1 blockade with chemotherapy improves survival in patients with advanced hepatoid adenocarcinoma of the stomach.

Contribution

This is the first multicenter retrospective study to evaluate PD-1 blockade plus chemotherapy as first-line treatment for hepatoid adenocarcinoma of the stomach.

Findings

The treatment achieved a 76% objective response rate and 88% disease control rate in patients with advanced hepatoid adenocarcinoma.

Median overall survival was 20.3 months, indicating significant survival benefits from the combination therapy.

The treatment was well tolerated, with white blood cell count decrease being the most common adverse event.

Abstract

This study aims to evaluate the efficacy and safety of programmed cell death protein 1 (PD-1) blockade in combination with chemotherapy for patients with advanced hepatoid adenocarcinoma of the stomach (HAS).

This study retrospectively collected data from 25 patients with advanced HAS who received first-line PD-1 blockade combined with chemotherapy across 6 centers between January 2018 and January 2024. Progression-free survival and overall survival were assessed using Kaplan-Meier curves.

This study included 25 patients with HAS, all of whom received a first-line treatment regimen combining PD-1 blockade and chemotherapy. The objective response rate and disease control rate were 76.0% and 88.0%, respectively. The median follow-up time was 13.1 months, with a median progression-free survival of 10.2 months (95% CI, 6.3-14.1) and a median overall survival of 20.3 months (95% CI, 11.3-29.4). A total of 20 patients (80.0%) experienced adverse reactions of varying degrees, with white blood cell count decreased (12, 48.0%) being the most common adverse event. Two patients experienced fatal adverse events (grade 5), both of which were unrelated to the PD-1 blockade.

Patients with HAS can derive survival benefits from first-line treatment with PD-1 blockade combined with chemotherapy, and the treatment is well tolerated. Furthermore, this pathological subtype may serve as a predictive indicator of favorable efficacy for PD-1 blockade, regardless of the patients’ programmed death-ligand 1 combined positive score.

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