Abstract 449P
Background
The safety and efficacy of neoadjuvant immunochemotherapy (nICT) for locally advanced gastric cancer (LAGC) remain controversial.
Methods
Patients with LAGC who received either nICT or neoadjuvant chemotherapy (nCT) at 3 tertiary referral teaching hospitals in China between January 2016 and October 2022 were analysed. After propensity-score matching (PSM), comparing the radiological response, pathological response rate, perioperative outcomes, and early recurrence between the two groups.
Results
After PSM, 585 patients were included, with 195 and 390 patients comprising the nICT and nCT groups, respectively. The nICT group exhibited a higher objective response rate (79.5% versus [vs.] 59.0%; P < 0.001), pathological complete response rate (14.36% vs. 6.41%; P = 0.002) and major pathological response rate (39.49% vs. 26.15%; P = 0.001) compared with the nCT group. The incidence of surgical complications (17.44% vs. 16.15%, P = 0.694) and proportion of perioperative textbook outcomes (80.0% vs. 81.0%; P = 0.767) were similar in both groups. The nICT group had a significantly lower proportion of early recurrence than the nCT group (16.9% vs. 26.2%; P = 0.022). Furthermore, the multivariable logistic analysis revealed that immunotherapy was an independent protective factor against early recurrence (odds ratio 0.54 [95% CI 0.34–0.86; P = 0.010). No significant difference was found in neoadjuvant therapy drug toxicity between the two groups (51.79% vs. 45.38%; P = 0.143).
Conclusions
Compared with nCT, nICT is safe and effective, which significantly enhanced objective and pathological response rates, and reduced the risk for early recurrence among patients with LAGC.
Legal entity responsible for the study
Fujian Medical University Union Hospital, Fuzhou, China.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.