High TMB Gastric Cancer Patients Benefit From ICI Therapy.

(CTN News) – A recent meta-analysis published in International Immunopharmacology has revealed that patients diagnosed with gastric cancer may experience better outcomes from immune checkpoint inhibitor (ICI) treatment if they possess a high tumor mutational burden (TMB).

The study found that patients with a high TMB had longer overall survival (OS) and progression-free survival (PFS), with Asian patients driving the benefits.

The meta-analysis included 11 retrospective studies of patients with Gastric Cancer or gastroesophageal Gastric Cancer who were treated with ICIs, with 9 studies conducted in Asian countries and 2 in non-Asian countries.

In 6 studies, patients were administered combination treatment, while in 5 studies, they received ICI monotherapy. The ICIs used in these studies were nivolumab, pembrolizumab, atezolizumab, tislelizumab, and toripalimab.

Based on data from 8 studies, the researchers discovered that patients with a high TMB had a significantly longer overall survival (OS) compared to those with a low TMB.

The hazard ratio (HR) was 0.65 with a 95% confidence interval (CI) of 0.55-0.77, and the p-value was less than 0.001.

Using data from 10 studies, the researchers also found that patients with a high TMB had a significantly longer progression-free survival (PFS) compared to those with a low TMB. The HR was 0.51 with a 95% CI of 0.33-0.77, and the p-value was 0.001.

Upon conducting a subgroup analysis, it was observed that the OS benefit was significant in Asian patients with a high TMB. The HR was 0.56 with a 95% CI of 0.43-0.72, and the p-value was less than 0.001. However, this benefit was not observed in non-Asian patients with a high TMB. The HR was 0.61 with a 95% CI of 0.32-1.16, and the p-value was 0.133.

In Asian patients with a high TMB, the PFS benefit was found to be Gastric Cancer significant (HR, 0.45; 95% CI, 0.28-0.72; P =.001). However, this benefit was not observed in non-Asian patients with a high TMB (HR, 0.68; 95% CI, 0.31-1.48; P =.322).

Interestingly, the OS in high-TMB patients remained similar regardless of whether they received combination therapy or monotherapy. On the other hand, the PFS benefit was significant in high-TMB patients who received monotherapy (HR, 0.39; 95% CI, 0.22-0.67; P =.001), but not in those who received combination therapy (HR, 0.84; 95% CI, 0.65-1.08; P =.192).

The researchers of this meta-analysis concluded that gastric cancer patients with high TMB, especially in Asian populations, experienced significant benefits from ICIs compared to those with low TMB. They also emphasized the need for a large number of randomized clinical trials (RCTs) to further establish TMB as a reliable predictor for the prognosis of gastric cancer patients treated with ICIs.

SEE ALSO:

The Resurgence of Alzheimer’s Vaccines in Light of Recent Drug Success