Based on the CheckMate 649 trial, nivolumab plus chemotherapy is the recommended first-line treatment for HER2-negative unresectable advanced or metastatic gastric, gastroesophageal junction (GEJ), or esophageal adenocarcinoma. This nationwide, multicenter, retrospective study evaluated the real-world effectiveness of this regimen in Turkish patients and identified subgroups that may experience superior outcomes. Conducted across 16 oncology centers in Turkey, this study retrospectively reviewed the clinical charts of adult patients diagnosed with HER2-negative unresectable advanced or metastatic gastric, GEJ, or esophageal adenocarcinoma from 2016 to 2023. This study included 111 patients (54 women, 57 men) with a median age of 58 years. The median progression-free survival (PFS) and overall survival (OS) were 11.7 months and 18.2 months, respectively, whereas the objective response rate (ORR) was 70.3%. Multivariable analyses revealed that previous curative surgery was a favorable independent prognostic factor for both PFS and OS. Conversely, an Eastern Cooperative Oncology Group performance status of 2 emerged as an adverse independent prognostic factor for OS. The safety profile of nivolumab plus chemotherapy was found to be manageable. Our findings support the use of nivolumab plus chemotherapy for the first-line treatment of Turkish patients with HER2-negative unresectable advanced or metastatic gastric, GEJ, or esophageal adenocarcinoma. Patient selection based on clinical characteristics is crucial for optimizing treatment outcomes.
基于CheckMate 649试验结果，纳武利尤单抗联合化疗已成为HER2阴性不可切除晚期或转移性胃、胃食管结合部（GEJ）或食管腺癌的推荐一线治疗方案。本项全国性多中心回顾性研究评估了该方案在土耳其患者中的真实世界疗效，并识别出可能获得更佳预后的亚组。研究覆盖土耳其16个肿瘤中心，回顾性分析了2016年至2023年诊断为HER2阴性不可切除晚期或转移性胃、GEJ或食管腺癌的成年患者临床资料。共纳入111例患者（女性54例，男性57例），中位年龄58岁。中位无进展生存期（PFS）和总生存期（OS）分别为11.7个月和18.2个月，客观缓解率（ORR）达70.3%。多变量分析显示，既往根治性手术是PFS和OS的有利独立预后因素；而美国东部肿瘤协作组体能状态评分为2分则是OS的不良独立预后因素。纳武利尤单抗联合化疗的安全性整体可控。本研究结果支持纳武利尤单抗联合化疗作为土耳其HER2阴性不可切除晚期或转移性胃、GEJ或食管腺癌患者的一线治疗方案。基于临床特征的患者选择对优化治疗结局至关重要。
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