Clinical efficacy and safety of PD-1/PD-L1 inhibitors in patients after surgery for advanced gastric cancer
ZHANG Di
DAI Ling
ZHANG Boya
WANG Yingjie
GUO Linna
XU Futian
LIU Lisha
Abstract：Objective To explore the clinical efficacy and safety of programmed death receptor 1(PD-1)/programmed death receptor ligand 1(PD-L1)inhibitors in patients after surgery for advanced gastric cancer.Methods Eighty patients with advanced gastric cancer after surgery who visited the hospital from January 2019 to January 2023 were selected as the research subjects.Among them,40 patients receiving conventional chemotherapy after surgery were included in the control group,while the other 40 patients receiving immunotherapy with PD-1/PD-L1 inhibitors after surgery were included in the observation group.The recurrence-free survival(RFS)and overall survival(OS),tumor markers[carcinoembryonic antigen(CEA)and cytokeratin 19 fragment antigen 21-1(CYFRA21-1)],occurrence of adverse reactions,expression of PD-1/PD-L1 in cancer tissues and adjacent tissues,and Karnofsky Performance Status(KPS)scores were compared between the two groups,and the influencing factors of the patient's prognosis was analyzed using a Cox proportional hazards model.Results The positive expression rates of PD-1 and PD-L1 in cancer tissues were significantly higher than those in adjacent tissues(P＜0.05).By the end of follow-up in June 2025,the median follow-up was 28.33 months.A total of 40 deaths and 2 patients lost to follow-up were recorded across both groups.The median 0S was 34.95 months(95％CI:26.56,52.01)in the observation group,and 25.71 months(95％CI:18.89,32.79)in the control group,showing a significant difference in OS between the two groups(HR=0.453,P=0.004).The median RFS was 20.01 months(95％CI:10.95,41.43)in the observation group,and 12.63 months(95％CI:7.29,17.58)in the control group,showing a significant difference in RFS between the two groups(HR=0.588,P=0.019).There was no significant difference in the incidence of recurrence and metastasis between the two groups(P＞0.05).After treatment,the levels of CEA and CYFRA21-1 in the observation group decreased more significantly than those in the control group(P＜0.05).There was no significant difference in the adverse reaction grades and the incidence of adverse reactions between the two groups(P＞0.05),nor in the KPS scores between the two groups(P＞0.05).PD-1 and PD-L1 expressions were risk factors affecting the prognosis of patients with advanced gastric cancer after surgery(P＜0.05).Conclusion PD-1/PD-L1 inhibitors have clinical advantages in improving the survival benefits of patients after surgery for advanced gastric cancer,with controllable safety.Therefore,the expression level of PD-1/PD-L1 can be used as a key indicator for prognostic assessment.
Keywords：advanced gastric cancerprogrammed death-1programmed death-ligand 1immunotherapycarcinoembryonic antigencytokeratin-19 fragment antigen 21-1adverse reaction
Publication Date：2025-11-28
Online Publishing Date：2025-12-11(First online date of this platform, not the publication date of the document)
Pages：6( 90-95 )