SynthesisBMC cancer2026
Immunotherapy combined with chemotherapy as first-line treatment for HER2-negative advanced gastric or gastroesophageal junction cancer: systematic review and Bayesian network meta-analysis based on specific PD-L1 expression levels.
Synthesis in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGastric/gastroesophageal junction cancer (G/GEJC) is a major global health concern. HER2-negative advanced cases, which are common, have a poor prognosis and high peritoneal metastasis rates. First-line chemotherapy has limitations, while immunotherapy combined with chemotherapy shows promise, the optimal regimen for patients with different PD-L1 expression levels remains unclear.
methodsWe conducted a systematic review and Bayesian network meta - analysis by searching PubMed, Embase, Cochrane Library, and Web of Science databases. Eight RCTs involving 7619 patients and 7 immunotherapy-chemotherapy regimens were included. Outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and grade ≥ 3 adverse events (AEs). This analysis evaluated the efficacy and safety of various first-line immunotherapy-combination chemotherapy regimens for patients with HER2-negative advanced G/GEJC. Additionally, we assessed treatment efficacy across different PD-L1 expression subgroups.This study was registered in the Prospective Register of Systematic Reviews (CRD420251028737).
resultsConventional meta-analysis showed that compared with chemotherapy alone, immunotherapy - chemotherapy significantly improved OS (HR = 0.79, 95% CI: 0.74-0.84), PFS (HR = 0.72, 95% CI: 0.68-0.77), and ORR (RR = 1.61, 95% CI: 1.45-1.80) in HER2-negative advanced G/GEJC patients. However, it also led to a higher incidence of grade ≥ 3 adverse events (AEs, RR = 1.18, 95% CI: 1.13-1.23). Subgroup analysis revealed that in patients with PD - L1 expression ≥ 1%, ≥ 5%, and ≥ 10%, this combination therapy significantly improved OS and PFS, with greater benefits at higher combined positive scores (CPS). Network meta - analysis indicated that for PD-L1 unselected patients, cadonilimab combined with chemotherapy was superior in OS, PFS, and ORR. In PD - L1 ≥ 1% patients, pembrolizumab plus chemotherapy had the best OS; in PD-L1 ≥ 5% patients, cadonilimab plus chemotherapy was optimal for OS and nivolumab plus chemotherapy for PFS; in PD-L1 ≥ 10% patients, sugemalimab plus chemotherapy was most effective for both OS and PFS.
conclusionIn conclusion, these findings support immunotherapy-combination chemotherapy as a superior first-line strategy for HER2-negative advanced G/GEJC. Different optimal regimens can be selected based on PD-L1 expression levels, providing evidence-based guidance for clinical decision-making.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.