Scholarlink

Background and objective <p>Neoadjuvant and perioperative immune checkpoint inhibitor (ICI)-based strategies are increasingly being investigated in locally advanced resectable gastric and gastroesophageal junction (GEJ) adenocarcinoma, but the overall efficacy and safety of these approaches remain uncertain. This systematic review and meta-analysis aimed to evaluate pathological response, surgical outcomes, radiological response, and treatment-related safety of ICI-containing preoperative regimens in this setting.</p> Methods <p>A systematic search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and Scopus was conducted from 2014 to 2026. Google Scholar was also searched as a supplementary source for gray literature and citation tracking. Studies evaluating neoadjuvant or perioperative ICI-based therapy in adults with locally advanced resectable gastric or GEJ adenocarcinoma were included. Pooled estimates for pathologic complete response (pCR), major pathologic response (MPR), objective response rate (ORR), R0 resection, and safety outcomes were calculated using random-effects models.</p> Results <p>Twenty studies were included. The pooled pCR rate was 22.8% (95% c.i. 18.6% to 27.6%), MPR was 49.5% (95% c.i. 41.8% to 57.1%), ORR was 60.6% (95% c.i. 42.0% to 76.6%), and R0 resection was 97.2% (95% c.i. 94.0% to 98.7%). The pooled rates of grade 3 or higher adverse events, immune-related adverse events, and postoperative surgical complications were 24.0% (95% c.i. 15.6% to 35.2%), 23.2% (95% c.i. 15.4% to 33.5%), and 26.2% (95% c.i. 19.1% to 34.7%), respectively.</p> Conclusion <p>Neoadjuvant or perioperative ICI-based therapy is associated with encouraging pathological response and high R0 resection rates in locally advanced resectable gastric and GEJ adenocarcinoma. However, the available evidence is limited by substantial clinical heterogeneity and immature survival data. Larger randomized studies with longer follow-up are needed to confirm long-term oncologic benefit and better define optimal patient selection.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Neoadjuvant immunotherapy for locally advanced resectable gastric and gastroesophageal junction adenocarcinoma: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月29日

查看全文
  • Ifrah Mohamud Osman,
  • Siyu Peng,
  • Heshi Liu,
  • Wang Zhen,
  • Shengjie Ma,
  • Quan Wang

摘要

Background and objective

Neoadjuvant and perioperative immune checkpoint inhibitor (ICI)-based strategies are increasingly being investigated in locally advanced resectable gastric and gastroesophageal junction (GEJ) adenocarcinoma, but the overall efficacy and safety of these approaches remain uncertain. This systematic review and meta-analysis aimed to evaluate pathological response, surgical outcomes, radiological response, and treatment-related safety of ICI-containing preoperative regimens in this setting.

Methods

A systematic search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and Scopus was conducted from 2014 to 2026. Google Scholar was also searched as a supplementary source for gray literature and citation tracking. Studies evaluating neoadjuvant or perioperative ICI-based therapy in adults with locally advanced resectable gastric or GEJ adenocarcinoma were included. Pooled estimates for pathologic complete response (pCR), major pathologic response (MPR), objective response rate (ORR), R0 resection, and safety outcomes were calculated using random-effects models.

Results

Twenty studies were included. The pooled pCR rate was 22.8% (95% c.i. 18.6% to 27.6%), MPR was 49.5% (95% c.i. 41.8% to 57.1%), ORR was 60.6% (95% c.i. 42.0% to 76.6%), and R0 resection was 97.2% (95% c.i. 94.0% to 98.7%). The pooled rates of grade 3 or higher adverse events, immune-related adverse events, and postoperative surgical complications were 24.0% (95% c.i. 15.6% to 35.2%), 23.2% (95% c.i. 15.4% to 33.5%), and 26.2% (95% c.i. 19.1% to 34.7%), respectively.

Conclusion

Neoadjuvant or perioperative ICI-based therapy is associated with encouraging pathological response and high R0 resection rates in locally advanced resectable gastric and GEJ adenocarcinoma. However, the available evidence is limited by substantial clinical heterogeneity and immature survival data. Larger randomized studies with longer follow-up are needed to confirm long-term oncologic benefit and better define optimal patient selection.