Yong Liu, Qiang Xue, Baogui Wang, Xuewei Ding, Rupeng Zhang, Xiaona Wang, Bin Ke, Xuejun Wang, Ning Liu, Jingyu Deng, Hongjie Zhan, Bin Li, Liangliang Wu, Mingzhi Cai, Li Zhang, Wenbai Huang, Peng Jin, Han Liang
{"title":"Conversion therapy with sintilimab combined with chemotherapy and apatinib in stage IV gastric cancer.","authors":"Yong Liu, Qiang Xue, Baogui Wang, Xuewei Ding, Rupeng Zhang, Xiaona Wang, Bin Ke, Xuejun Wang, Ning Liu, Jingyu Deng, Hongjie Zhan, Bin Li, Liangliang Wu, Mingzhi Cai, Li Zhang, Wenbai Huang, Peng Jin, Han Liang","doi":"10.1002/ijc.35511","DOIUrl":null,"url":null,"abstract":"<p><p>In selected patients with stage IV gastric cancer, radical surgery after conversion therapy may increase survival benefit; however, there is currently no standard protocol for conversion therapy. We explored the feasibility and efficacy of sintilimab plus two-drug chemotherapy (S-1 plus nab-paclitaxel) and apatinib as conversion therapy in patients with stage IV gastric cancer in China. This was a prospective, single-arm, single-center, phase 2 study. The primary endpoint was the R0 conversion rate, defined as the proportion of R0 surgical patients to the total number of patients treated. Of 56 patients screened, 47 were enrolled, received preoperative treatment, and were evaluated for tumor response. Most patients (28/47; 59.6%) had two or three unresectable factors. The objective response rate and disease control rate were 53.2% and 97.9%, respectively. Of the 46/47 patients who achieved disease control, 35 underwent surgery. The R0 conversion rate was 51.1% (24/47). A pathological complete response was observed in 14.3% (5/35) of patients. Median overall survival and event-free survival were 25.7 and 15.3 months, respectively. Overall survival and event-free survival were significantly better in surgical patients compared with non-surgical patients (p < 0.001). In the surgical population, R1/R2 resection was the only significant independent predictor of unfavorable event-free survival by multivariate analysis (p = 0.015). There were no chemotherapy- or perioperative-related deaths. The safety profile was manageable. Sintilimab plus chemotherapy and apatinib followed by conversional resection may be a new feasible and safe option for initially unresectable gastric cancer, potentially leading to long-term survival or even cure.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ijc.35511","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
In selected patients with stage IV gastric cancer, radical surgery after conversion therapy may increase survival benefit; however, there is currently no standard protocol for conversion therapy. We explored the feasibility and efficacy of sintilimab plus two-drug chemotherapy (S-1 plus nab-paclitaxel) and apatinib as conversion therapy in patients with stage IV gastric cancer in China. This was a prospective, single-arm, single-center, phase 2 study. The primary endpoint was the R0 conversion rate, defined as the proportion of R0 surgical patients to the total number of patients treated. Of 56 patients screened, 47 were enrolled, received preoperative treatment, and were evaluated for tumor response. Most patients (28/47; 59.6%) had two or three unresectable factors. The objective response rate and disease control rate were 53.2% and 97.9%, respectively. Of the 46/47 patients who achieved disease control, 35 underwent surgery. The R0 conversion rate was 51.1% (24/47). A pathological complete response was observed in 14.3% (5/35) of patients. Median overall survival and event-free survival were 25.7 and 15.3 months, respectively. Overall survival and event-free survival were significantly better in surgical patients compared with non-surgical patients (p < 0.001). In the surgical population, R1/R2 resection was the only significant independent predictor of unfavorable event-free survival by multivariate analysis (p = 0.015). There were no chemotherapy- or perioperative-related deaths. The safety profile was manageable. Sintilimab plus chemotherapy and apatinib followed by conversional resection may be a new feasible and safe option for initially unresectable gastric cancer, potentially leading to long-term survival or even cure.
期刊介绍:
The International Journal of Cancer (IJC) is the official journal of the Union for International Cancer Control—UICC; it appears twice a month. IJC invites submission of manuscripts under a broad scope of topics relevant to experimental and clinical cancer research and publishes original Research Articles and Short Reports under the following categories:
-Cancer Epidemiology-
Cancer Genetics and Epigenetics-
Infectious Causes of Cancer-
Innovative Tools and Methods-
Molecular Cancer Biology-
Tumor Immunology and Microenvironment-
Tumor Markers and Signatures-
Cancer Therapy and Prevention