Evidence map›Paper›PMID 41341592›Full record

SynthesisFrontiers in immunology2025

Long-term outcomes of PD-1 inhibitors plus chemotherapy as first-line treatment for advanced HER2-negative gastric cancer: an updated systematic review and meta-analysis.

Juping Tong, Shanmei Zhou, Shan Yin, Xiaojian Wang, Xinyi Liang, Jieru Quan, Duo Zhang, Shanguang Wu, Yilun Wei

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Juping TongThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Shanmei ZhouThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Shan YinThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Xiaojian WangThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Xinyi LiangThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Jieru QuanSchool of Economics and Management, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Duo ZhangGuangxi College Key Laboratory of Innovation Research on Medical and Engineering Integration, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Shanguang WuGuangxi College Key Laboratory of Innovation Research on Medical and Engineering Integration, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.
Yilun WeiThe First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: This meta-analysis was designed to compare the long-term outcomes of first-line programmed cell death protein 1 (PD-1) inhibitors plus chemotherapy versus chemotherapy in patients with advanced HER2-negative gastric cancer (GC). Materials and methods: Four databases (PubMed, Embase, Web of Science, and the Cochrane Library) were searched for randomized controlled trials (RCTs) comparing first-line PD-1 inhibitors plus chemotherapy to chemotherapy in patients with advanced HER2-negative GC. The search was conducted from the databases establishment to October 11, 2025. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), treatment-related adverse events (TRAEs), and Grade≥3 TRAEs were subjected to meta-analyses. Results: Six RCTs were included in the meta-analysis. The meta-analysis included a group of 6038 patients diagnosed with untreated advanced HER2-negative GC. Within this cohort, 3026 patients were administered first-line PD-1 inhibitors together with chemotherapy, while 3012 patients received first-line chemotherapy alone. Compared with chemotherapy, first-line PD-1 inhibitors plus chemotherapy yielded superior OS (HR = 0.91; 95% CI 0.89 to 0.93; P<0.01), PFS (HR = 0.89, 95%CI 0.87 to 0.91 P<0.01), and ORR (RR = 1.22, 95% CI, 1.16 to 1.29, P<0.01). With regards to safety, first-line PD-1 inhibitors plus chemotherapy exhibited a greater likelihood of encountering TRAEs (RR = 1.02, 95% CI: 1.00 to 1.04, P = 0.03) and Grade≥3 TRAEs (RR = 1.16, 95% Cl: 1.08 to 1.25, P<0.01) in comparison to chemotherapy. Conclusions: Compared with chemotherapy alone, PD-1 inhibitors plus chemotherapy as first-line therapy provided improved OS, PFS, and ORR. Furthermore, the heightened efficacy of PD-1 inhibitors plus chemotherapy was accompanied by a rise in TRAEs and Grade≥3 TRAEs. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251015248.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsErb-b2 Receptor Tyrosine KinasesImmune Checkpoint InhibitorsProgrammed Cell Death 1 ReceptorStomach NeoplasmsHumansRandomized Controlled Trials as TopicTreatment OutcomeERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesImmune Checkpoint InhibitorsPDCD1 protein, humanProgrammed Cell Death 1 Receptorchemotherapygastric cancermeta-analysisobjective response rateoverall survivalPD-1 inhibitorsprogression-free survivaltreatment-related adverse events

Identifiers

PMID41341592
PMCPMC12670175

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.