Efficacy and safety of re-immunotherapy in advanced gastric cancer patients who have previously failed immunotherapy
Objective To evaluate the efficacy and safety of re-immunotherapy in advanced gastric cancer patients who have progressed after initial immune checkpoint inhibitors(ICIs)therapy.Methods A retrospective analysis from October 2019 to October 2022 at Wuhu Second People's Hospital of 17 cases of advanced gastric cancer patients who received re-immunotherapy after progression on initial immunotherapy.Initial immunotherapy regimens included ICIs(pembrolizumab,nivolumab,sintilimab,camrelizumab,toripalimab or envafolimab)combined with chemotherapy(fluorouracil,taxus or oxaliplatin)or angiogenesis inhibitors(apatinib,fruquintinib).Received re-immunotherapy included original immunotherapeutic agents,programmed cell death protein 1(PD-1)antibodies,and programmed death-ligand 1(PD-L1)antibodies interchange,and PD-1 antibody interchange.Other therapies were optional between two courses of immunotherapy.Survival analysis used Kaplan-Meier method.Results Median overall survival(OS)of 17 advanced gastric cancer patients was 18 months.During initial immunotherapy,11 patients(64.7％)achieved partial response(PR),and 4 patients(23.5％)achieved stable disease(SD),with median progression-free survival(PFS)of 6 months.After re-immunotherapy,2 patients(11.8％)achieved PR,8 patients(47.1％)achieved SD,with median PFS of 3 months.Disease control rate(DCR)after re-ICIs in patients who responded best to initial immunotherapy was 81.8％(9 out of 11 patients).Most immune-related adverse events during re-immunotherapy were grades 1-2,with no treatment discontinuations due to severe adverse events.Conclusion Received re-immunotherapy may provide benefits with good safety for advanced gastric cancer patients who progressed after initial ICIs therapy,presenting a viable treatment option.
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