Evidence map›Paper›PMID 33743112›Full record

Trial reportGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2021

Nivolumab in previously treated advanced gastric cancer (ATTRACTION-2): 3-year update and outcome of treatment beyond progression with nivolumab.

Narikazu Boku, 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 IIIRandomized 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, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 7 pooled it
8.0field-weighted citation impact, top 2% 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

79 citing papers in PubMed, 7 syntheses or guidelines pooled it, 121 citations in OpenAlex.

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  10. Exploration of predictors of benefit from nivolumab monotherapy for patients with pretreated advanced gastric and gastroesophageal junction cancer: post hoc subanalysis from the ATTRACTION-2 study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2022
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  13. Long-term quality of life, financial toxicity, and decision regret following therapeutic and prophylactic gastrectomy for cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 20 institutions in 4 countries.

Narikazu BokuDivision of Gastrointestinal Medical Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. nboku@ncc.go.jp.ORCID 0000-0002-1438-707X
Taroh SatohFrontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan.
Min-Hee RyuDepartment of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 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 YehDepartment of Medical Oncology, National 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, Cancer Research Institute, Seoul National University College of Medicine , 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.
Taihei NishiyamaMedical Information, Medical Affairs, Ono Pharmaceutical Co., Ltd., Osaka, Japan.
Li-Tzong ChenNational Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan.
Yoon-Koo KangDepartment of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Ulsan College · KRAichi Cancer Center · JPChang Gung University · TWChiba Cancer Center · JPChina Medical University · TWHyogo Prefectural Cancer Center · JPJapanese Foundation For Cancer Research · JPKanagawa Prefectural Hospital Organization · JPKaohsiung Medical University · TWKeio University · JPKorea University · KRKyungpook National University · KRNara Medical University Hospital · JPNational Cancer Centre Japan · JPNational Taiwan University · TWOno Pharmaceutical (Japan) · JPSamsung Medical Center · KRSeoul National University Bundang Hospital · KRSeoul National University Hospital · KRTaipei Veterans General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundATTRACTION-2 demonstrated that nivolumab improved overall survival (OS) vs placebo in patients with advanced gastric cancer treated with ≥ 2 chemotherapy regimens. However, its long-term efficacy and outcome of treatment beyond progression (TBP) with nivolumab have not been clarified.

methodsThe 3-year follow-up data were collected. A subset analysis was performed to explore the efficacy of TBP by assessing postprogression survival (PPS) after the first event of disease progression.

resultsOverall, 493 patients were randomized (2:1) to receive nivolumab (n = 330) or placebo (n = 163). With a median follow-up of 38.5 (range 36.1-47.5) months, OS of the nivolumab group was significantly longer compared to the placebo group (median 5.3 vs 4.1 months; 3-year survival rate, 5.6% vs 1.9%; hazard ratio [HR], 0.62 [95% confidence interval (CI) 0.50-0.75], P < 0.0001). The median OS of responders (n = 32) who achieved complete response or partial response was 26.7 months and the 3-year survival rate was 35.5% in the nivolumab group. Overall, 109 patients in the nivolumab group and 37 patients in the placebo group received TBP. PPS tended to be longer in the nivolumab group vs placebo group (median 5.8 vs 4.5 months; HR [95% CI], 0.69 [0.47-1.01], P = 0.057). In contrast, PPS was similar between both treatment groups in non-TBP patients (median 2.3 vs 2.2 months; HR 0.90, P = 0.42).

conclusionsLong-term efficacy of nivolumab was confirmed at the 3-year follow-up, and a survival benefit of TBP with nivolumab was suggested. Biomarkers for selecting patients suitable for TBP with nivolumab should be identified in the future.

Indexed as

AdultAgedAntineoplastic Agents, ImmunologicalDisease ProgressionDouble-Blind MethodFemaleFollow-Up StudiesHumansMaleMiddle AgedNivolumabProgression-Free SurvivalStomach NeoplasmsSurvival RateTreatment OutcomeAntineoplastic Agents, ImmunologicalNivolumabATTRACTION-2Gastric or gastroesophageal junction cancerLong-term efficacyNivolumabTreatment beyond progression

Identifiers

PMID33743112
PMCPMC8205916
OpenAlexW3137268919

What OpenQuestion holds

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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.