SynthesisFrontiers in immunology2026
Immune checkpoint inhibitors plus trastuzumab and chemotherapy for the treatment of advanced HER2-positive gastric and gastroesophageal junction cancers: a systematic review and meta-analysis.
Synthesis in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Background: HER2-positive gastric and gastroesophageal junction (GEJ) cancers have poor prognosis despite standard trastuzumab-based chemotherapy. Immune checkpoint inhibitors (ICIs) may enhance therapeutic efficacy when combined with trastuzumab. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Cochrane Library, Embase, and Scopus were searched up to December 29, 2025. Studies evaluating ICIs plus trastuzumab and chemotherapy versus trastuzumab-based therapy alone were included. Kaplan-Meier curves were digitized using WebPlotDigitizer and reconstructed to individual participant data (IPD). Pooled survival outcomes, objective response rate (ORR), disease control rate (DCR), and safety were analyzed. Results: Six studies including 1,097 patients were included. ICIs plus trastuzumab and chemotherapy significantly improved median progression-free survival (10.4 vs. 8.27 months; HR 0.6951, p<0.0001) and overall survival (20.4 vs. 17.2 months; HR 0.8104, p=0.004) compared with control. ORR (OR 1.85, p<0.00001) and DCR (OR 2.46, p=0.006) were also superior. Grade ≥3 adverse events were similar between groups. Conclusions: ICIs combined with trastuzumab and chemotherapy improve survival and response rates in HER2-positive gastric/GEJ cancers with manageable toxicity, supporting their integration into treatment strategies. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420261280958.
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