Evidence map›Paper›PMID 39833372›Full record

SynthesisJournal of gastrointestinal cancer2025

PD-1/PD-L1 Inhibitors Increase Pathological Complete Response in Locally Advanced Gastric Cancer: A Meta-analysis and Trial Sequential Analysis.

Francisco Cezar Aquino de Moraes, Vitor Kendi Tsuchiya Sano, Barbara Lins Silva, Ana Laura Soares Silva, Stellanny Cilene Rodrigues Castro, Michele Kreuz, Lilianne Rodrigues Fernandes, Francinny Alves Kelly, Rommel Mario Rodríguez Burbano

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of gastrointestinal cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 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, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  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

9 authors.

Francisco Cezar Aquino de MoraesFederal University of Pará, R. Augusto Corrêa, GuamáBelem, Pará, nº0166073-005, Brazil. francisco.cezar2205@gmail.com.
Vitor Kendi Tsuchiya SanoFederal University of Acre, Rio Branco, Acre, 69920-900, Brazil.
Barbara Lins SilvaVancouver Island Health Authority, 1947 Cook St, Victoria, BC, V8T 3P7, Canada.
Ana Laura Soares SilvaFederal University of Triângulo Mineiro, Uberaba, Minas Gerais, 38025-180, Brazil.
Stellanny Cilene Rodrigues CastroFederal University of Pará, R. Augusto Corrêa, GuamáBelem, Pará, nº0166073-005, Brazil.
Michele KreuzLutheran University of Brazil, Rio Grande Do Sul, Canoas, 92425-020, Brazil.
Lilianne Rodrigues FernandesAfya Abaetetuba, Abaetetuba, Pará, 68440-000, Brazil.
Francinny Alves KellyDante Pazzanese Cardiology Institute, São Paulo, São Paulo, 040012-909, Brazil.
Rommel Mario Rodríguez BurbanoOphir Loyola Hospital, Belém, Pará, 66063-240, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveGastric cancer (GC) remains a leading cause of morbidity and mortality worldwide. The current standard of care involves neoadjuvant chemotherapy (NACT) followed by radical gastrectomy. This study aims to evaluate the efficacy of neoadjuvant therapy with PD-1/PD-L1 inhibitors in comparison to chemotherapy alone for patients with locally advanced gastric cancer (LAGC).

methodsWe conducted a systematic search of PubMed, Web of Science, and Embase to identify studies examining the addition of PD-1/PD-L1 inhibitors to neoadjuvant therapy for LAGC. Odds ratios (OR) were calculated for binary outcomes, such as pathological complete response (pCR), with corresponding 95% confidence intervals (CI).

resultsSeven studies were included, encompassing a total of 1772 patients. Baseline median age ranged from 31 to 75 years. Most patients had an ECOG performance status score of 0 (942 patients), while 294 had an ECOG score of 1. The estimated pCR (OR 5.94, 95% CI 3.98-8.87; p < 0.000001) significantly favored the PD-1/PD-L1 inhibitors combined with chemotherapy over chemotherapy alone. Additionally, the incidence of certain adverse events increased significantly in the intervention group, including any-grade hypothyroidism (OR 4.55, 95% CI 2.27-9.10; p = 0.000019) and rash (OR 1.74, 95% CI 1.10-2.76; p = 0.017). Conversely, the control group showed a statistically significant lower incidence of grade ≥ 3 fatigue (OR 2.80, 95% CI 1.15-6.85; p = 0.024) compared to the intervention group.

conclusionThis systematic review and meta-analysis indicate that the addition of PD-1/PD-L1 inhibitors to neoadjuvant chemotherapy is associated with a higher pathological complete response rate compared to chemotherapy alone in patients with locally advanced gastric cancer.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsB7-H1 AntigenImmune Checkpoint InhibitorsProgrammed Cell Death 1 ReceptorStomach NeoplasmsAgedGastrectomyHumansNeoadjuvant TherapyB7-H1 AntigenCD274 protein, humanImmune Checkpoint InhibitorsPDCD1 protein, humanProgrammed Cell Death 1 ReceptorAdvanced gastric cancerAnti-PD-1/PD-L1Meta-analysisNeoadjuvant

Identifiers

PMID39833372

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.