Clinical evaluation of nivolumab and ipilimumab in treatment of patients with advanced gastric cancer

Gu Li-lei; Zhou Yu-qi; Shen Hong-shi; Xue Lian; Wu Ya-ting

doi:10.3969/j.issn.1672-8157.2025.02.013

Abstract：Objective To investigate the therapeutic efficacy of nivolumab combined with ipilimumab in the treatment of multiple advanced gastric cancer.Methods Ninety-four patients with advanced gastric cancer admitted to The 904th Hospital of the Joint Logistics Support Force of Chinese People's Liberation Army between June 2022 and June 2024 were recruited for this study.These patients were randomly divided into a control group(n=47)and a study group(n=47)utilizing the random number table method.The patients in the control group were treated with nivolumab,and those in the study group with nivolumab and ipilimumab.The number of patients with complete response(CR),partial response(PR),stable disease(SD),and progressive disease(PD)was counted and objective sustained release rate(ORR)was calculated.Serum tumor marker carcinoembryonic antigen(CEA)and car-bohydrate antigen 19-9(CA19-9)levels,CD4+ratio,CD8+ratio and CD4+/CD8+levels were detected and adverse reactions occurred during treatment were recorded.Results After treatment,the ORR of the study group was 53.19%(25/47),which was significantly higher than that of the control group(27.66%,13/47)(χ2=6.361,P=0.012).Both groups showed reduced levels of CEA and CA19-9 as compared with the baseline,with the study group demonstrating lower levels((5.17±1.23)ng·mL-1,(25.74±3.12)U·mL-1)than the control((6.28±1.36)ng·mL-1,(28.41±3.68)U·mL-1),and the differences were statistically significant(t=4.150,3.794,both P<0.05).Additionally,CD4+and CD4+/CD8+ratios were increased in both groups after treatment,with the study group exhibiting higher val-ues((45.86±3.85)%,(1.59±0.23))than the control((41.78±3.33)%,(1.38±0.21)),and the differences were statistically significant(t=5.495,4.623,both P<0.05).Conversely,CD8+levels were decreased in both groups,with the study group showing lower values((28.84±3.13)%)than the control((30.27±3.38)%),and the difference was statistically significant(t=2.128,P=0.036).Regarding total adverse reaction rate,the study group had 78.72%(37/47)while the control group had 70.21%(33/47),showing no statistical-ly significant difference between the two groups(χ2=1.229,P=0.268).Conclusion Using nivolumab combined with ipilimumab has high efficacy in the treatment of advanced gastric cancer since it can reduce the levels of serum tumor-related markers CEA and CA19-9,improve the distribution of T lymphocyte subsets,and has a favorable safety profile.