Evidence map›Paper›PMID 39573989›Full record

SynthesisBMC gastroenterology2024

Efficacy and safety of Nivolumab in advanced gastric and gastroesophageal junction cancer: a meta-analysis of randomized controlled trials.

Xinming Lei, Weimin Huo, Tian Xu, Jianguang Xu, Maoning Liu, Chengjiang Liu, Zhangyuan Gu

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
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

7 authors.

Xinming Lei *The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China.
Weimin Huo *Department of Pharmacy, Shijiazhuang Fouth Hospital, Shijiazhuang, 050200, Hebei, China.
Tian Xu *Xi'an No.3 Hospital, Xi'an, 710000, Shaanxi, China.
Jianguang XuThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China.
Maoning LiuThe Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China.
Chengjiang LiuDepartment of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Anhui, 246000, China. mrliu0420@foxmail.com.
Zhangyuan GuShanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China. guzhangyuanqq@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background*CoNivolumab, an immune checkpoint inhibitor, has shown promise in treating advanced unresectable gastric and gastroesophageal junction cancer. This meta-analysis aims to evaluate the efficacy and safety of Nivolumab, alone and in combination with chemotherapy, in this patient population.

methodsA systematic review and meta-analysis were conducted according to PRISMA guidelines, using data from PubMed, Embase, CENTRAL, Web of Science, and CNKI up to June 3, 2024. Eight randomized controlled trials (RCTs) involving 3729 patients were included. The primary outcomes were overall survival (OS) and progression-free survival (PFS), while safety was assessed through adverse events (AEs) and grade ≥ 3 AEs. Effect sizes were measured using mean differences (MD) and relative risks (RR), with 95% confidence intervals (CIs).

resultsNivolumab significantly extended OS (MD = 2.29, 95% CI: 1.48, 3.09) and PFS (MD = 0.69, 95% CI: 0.32, 1.06) compared to controls. Subgroup analysis showed that both Nivolumab monotherapy (OS: MD = 2.52, 95% CI: 0.81, 4.23; PFS: MD = 0.16, 95% CI: 0.11, 0.22) and Nivolumab combined with chemotherapy (OS: MD = 2.06, 95% CI: 0.56, 3.57; PFS: MD = 1.53, 95% CI: 0.32, 1.06) improved OS and PFS. While the overall risk of AEs was not significantly increased, Nivolumab monotherapy significantly increased the risk of AEs (RR = 1.47, 95% CI: 1.16, 1.87), whereas Nivolumab combined with chemotherapy did not (RR = 1.03, 95% CI: 0.97, 1.09). Both treatments increased the risk of grade ≥ 3 AEs (RR = 1.24, 95% CI: 1.12, 1.36).

conclusionNivolumab, both alone and in combination with chemotherapy, improves OS and PFS in patients with advanced gastric and gastroesophageal junction cancer. However, careful patient monitoring is necessary due to the increased risk of severe AEs, particularly with monotherapy.

Indexed as

Esophageal NeoplasmsEsophagogastric JunctionNivolumabRandomized Controlled Trials as TopicStomach NeoplasmsAntineoplastic Agents, ImmunologicalAntineoplastic Combined Chemotherapy ProtocolsHumansImmune Checkpoint InhibitorsProgression-Free SurvivalTreatment OutcomeAntineoplastic Agents, ImmunologicalImmune Checkpoint InhibitorsNivolumabAdverse eventsGastric cancerGastroesophageal junction cancerImmunotherapyMeta-analysisNivolumab

Identifiers

PMID39573989
PMCPMC11583461

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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.