Evidence map›Paper›PMID 31863227›Full record

Trial reportGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2020

A phase 3 study of nivolumab in previously treated advanced gastric or gastroesophageal junction cancer (ATTRACTION-2): 2-year update data.

Li-Tzong Chen, Taroh Satoh, Min-Hee Ryu, Yee Chao, Ken Kato, Hyun Cheol Chung, Jen-Shi Chen, Kei Muro, Won Ki Kang, Kun-Huei Yeh and 15 more

Open access · hybridAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 144 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
144citing papers in PubMed, 14 pooled it
10.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

144 citing papers in PubMed, 14 syntheses or guidelines pooled it, 227 citations in OpenAlex.

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84 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

25 authors at 20 institutions in 3 countries.

Li-Tzong ChenNational Institute of Cancer Research, National Health Research Institutes, National Cheng Kung University, Tainan, Taiwan.
Taroh SatohFrontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan.
Min-Hee RyuDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Yee ChaoDepartment of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
Ken KatoDivision of Gastrointestinal Medical Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Hyun Cheol ChungDivision of Medical Oncology, Yonsei Cancer Center, Song-Dang Institute for Cancer Research, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
Jen-Shi ChenDivision of Hematology and Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Kei MuroDepartment of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
Won Ki KangDivision of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kun-Huei YehNational Taiwan University Cancer Center, Taipei, Taiwan.
Takaki YoshikawaDepartment of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Sang Cheul OhDivision of Hematology and Oncology, Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea.
Li-Yuan BaiDivision of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Takao TamuraDepartment of Medical Oncology, Faculty of Medicine, Kindai University, Osakasayama, Japan.
Keun-Wook LeeDivision of Hematology and Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
Yasuo HamamotoKeio Cancer Center, Keio University School of Medicine, Tokyo, Japan.
Jong Gwang KimKyungpook National University School of Medicine, Daegu, South Korea.
Keisho ChinDepartment of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
Do-Youn OhDepartment of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Keiko MinashiClinical Trial Promotion Department, Chiba Cancer Center, Chiba, Japan.
Jae Yong ChoDepartment of Medical Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Masahiro TsudaDepartment of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan.
Hiroki SameshimaMedical Oncology, Medical Affairs, Ono Pharmaceutical Co., Ltd., Osaka, Japan.
Yoon-Koo KangDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Narikazu BokuDivision of Gastrointestinal Medical Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. nboku@ncc.go.jp.
Ulsan College · KRAichi Cancer Center · JPChiba Cancer Center · JPChina Medical University · TWHyogo Prefectural Cancer Center · JPJapanese Foundation For Cancer Research · JPKeio University · JPKindai University · JPKorea University · KRKyungpook National University · KRLinkou Chang Gung Memorial Hospital · TWNational Health Research Institutes · TWNational Taiwan University · TWOno Pharmaceutical (Japan) · JPSamsung Medical Center · KRSeoul National University Bundang Hospital · KRSeoul National University Hospital · KRTaipei Veterans General Hospital · TWThe University of Osaka · JPTokyo National Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNivolumab showed improvement in overall survival (OS) in ATTRACTION-2, the first phase 3 study in patients with gastric/gastroesophageal junction (G/GEJ) cancer treated with ≥ 2 chemotherapy regimens. The 2-year follow-up results of ATTRACTION-2 are presented herein.

methodsATTRACTION-2 was a randomized, double-blind, placebo-controlled, phase 3 trial (49 sites; Japan, South Korea, and Taiwan). The median (min-max) follow-up period was 27.3 (24.1-36.3) months. The primary endpoint was OS. A subanalysis of OS was performed based on best overall response and tumor-programmed death ligand-1 (PD-L1) expression status.

resultsOverall, 493 of 601 screened patients were randomized (2:1) to receive nivolumab (330) or placebo (163). OS (median [95% confidence interval; CI]) was significantly longer in the nivolumab group (5.26 [4.60-6.37] vs 4.14 [3.42-4.86] months in placebo group) at the 2-year follow-up (hazard ratio [95% CI], 0.62 [0.51-0.76]; P < 0.0001). A higher OS rate was observed in the nivolumab vs placebo group at 1 (27.3% vs 11.6%) and 2 years (10.6% vs 3.2%). The OS benefit was observed regardless of tumor PD-L1 expression. Among patients with a complete or partial response (CR or PR) in the nivolumab group, the median OS (95% CI) was 26.6 (21.65-not applicable) months; the OS rates at 1 and 2 years were 87.1% and 61.3%, respectively. No new safety signals were identified.

conclusionsNivolumab treatment resulted in clinically meaningful long-term improvements in OS in patients with previously treated G/GEJ cancer. The long-term survival benefit of nivolumab was most evident in patients with a CR or PR.

Indexed as

Salvage TherapyAgedAntineoplastic Agents, ImmunologicalDouble-Blind MethodEsophageal NeoplasmsEsophagogastric JunctionFemaleFollow-Up StudiesHumansJapanMaleMiddle AgedNivolumabPrognosisRepublic of KoreaStomach NeoplasmsAntineoplastic Agents, ImmunologicalNivolumabGastric cancerGastroesophageal junction cancerLong-termNivolumabPlacebo

Identifiers

PMID31863227
PMCPMC7165140
OpenAlexW2994683483

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.