Evaluating comparative effectiveness of pembrolizumab-based therapy versus chemotherapy in treatment of gastric carcinoma: a systematic review and meta-analysis of randomized controlled trials
- Haleema Mansoor 1, Maheen Gohar 2, Asma Attaria 1, Faiza Fatima Karim 1, Umaimah Naeem 1, Mohsin Khan 1, Javed Iqbal 3
- Haleema Mansoor 1, Maheen Gohar 2, Asma Attaria 1
- 1Jinnah Sindh Medical University, Karachi, Pakistan.
- 2Liaquat University of Health Sciences, Jamshoro, Pakistan.
- 3Nursing Department, Communicable Disease Center, Hamad Medical Corporation, P.O Box 3050, Doha, Qatar. jiqbal3@hamad.qa.
- 0Jinnah Sindh Medical University, Karachi, Pakistan.
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View abstract on PubMed
Summary
This summary is machine-generated.Pembrolizumab combined with chemotherapy significantly improves survival and response rates in advanced gastric cancer patients. However, this combination therapy also increases adverse events, requiring careful patient monitoring.
Area Of Science
- Oncology
- Immunotherapy
- Gastroenterology
Background
- Gastric cancer, particularly gastro-esophageal junction cancer, is a leading cause of cancer mortality worldwide.
- Advanced stages of gastric cancer have poor survival rates.
- Standard chemotherapy for gastric cancer has limitations in efficacy and significant side effects.
Purpose Of The Study
- To evaluate the efficacy and safety of pembrolizumab-based therapies compared to standard chemotherapy for advanced gastric cancer.
- To analyze overall survival (OS), progression-free survival (PFS), and objective response rate (ORR).
Main Methods
- A systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched major databases including Google Scholar, Scopus, PubMed, and Cochrane Library.
- Included 4 RCTs with 2,831 adult patients with gastric carcinoma.
Main Results
- Pembrolizumab monotherapy did not significantly improve OS versus chemotherapy.
- Pembrolizumab combined with chemotherapy significantly improved OS (HR 0.80) and PFS (HR 0.78).
- Objective response rate (ORR) was superior with pembrolizumab plus chemotherapy (RR 1.24), but adverse events were more frequent.
Conclusions
- Pembrolizumab combined with chemotherapy enhances survival and response rates in advanced gastric cancer, especially in patients with high PD-L1 expression.
- While effective, pembrolizumab-based combination therapy is associated with increased adverse events.
- Close patient monitoring is essential when using pembrolizumab-based therapies for advanced gastric cancer.
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