Efficacy and safety of systemic regimens for resectable gastric and gastroesophageal junction adenocarcinoma: A network meta-analysis of randomized controlled trials.
Rafael Lara Nohmi, Isadora Mamede, Turkan Aliyeva et al.
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In 30 seconds
This network meta-analysis evaluated the efficacy and safety of systemic therapy regimens for resectable locally advanced gastric and gastroesophageal junction adenocarcinoma across 30 trials involving 11,547 patients. The study found that perioperative taxane-based triplet chemotherapy plus an immune checkpoint inhibitor ranked highest for overall survival (SUCRA = 0.952) and disease-free survival (SUCRA = 0.959).
Key findings
- P-Trp-Tax + ICI showed a numerically favorable trend for overall survival (HR 0.79; 95% CrI, 0.59-1.05).
- A more consistent benefit was observed for disease-free survival (HR 0.72; 95% CrI, 0.56-0.93).
- Toxicity profiles were consistent with known patterns, without increased high-grade adverse events with ICIs.
Why it matters
The findings highlight the potential benefits of intensified treatment strategies in improving survival outcomes for patients with resectable gastric and gastroesophageal junction adenocarcinoma, which is crucial for informing clinical decision-making.
What to keep in mind
Estimates were limited by heterogeneity and sparse data, and the reliance on indirect comparisons raises caution in interpretation.