Prognostic Impact of Claudin18.2 and TROP2 Expression in Advanced Gastric Cancer Treated With Nivolumab.
The combination of chemotherapy and nivolumab has become the standard first-line therapy for advanced gastric cancer (AGC) following the results of the CheckMate 649 and ATTRACTION-4 trials. Claudin18.2 (CLDN18.2) and trophoblast cell surface antigen 2 (TROP2) have recently emerged as potential therapeutic targets in AGC. However, their association with the efficacy of nivolumab is not known. The aim of this study was to clarify the efficacy of nivolumab according to CLDN18.2 and TROP2 expression in AGC.
This retrospective study included patients with AGC who had received systemic chemotherapy, with the primary objective of evaluating clinical outcomes in patients treated with nivolumab monotherapy after third-line therapy, by CLDN18.2 and TROP2 expression. The endpoints were overall survival after starting systemic chemotherapy and progression-free survival and overall survival after starting nivolumab monotherapy after third line treatment (Nivo-PFS and Nivo-OS, respectively).
The primary analysis included 69 patients treated with nivolumab monotherapy out of the 121 patients selected from the database. No significant difference in Nivo-PFS or Nivo-OS was found between the CLDN18.2-positive and CLDN18.2-negative populations or between the TROP2-positive and TROP2-negative populations. In the CLDN18.2-positive population, multivariable analysis showed that combined positive score (CPS) ≥1 was associated with significantly longer OS, Nivo-PFS, and Nivo-OS (p=0.03, p=0.03, p<0.01, respectively). In the TROP2-positive population, CPS ≥1 showed a tendency toward better prognosis for Nivo-OS (p=0.31) in the multivariable analysis.
Among patients undergoing nivolumab treatment, CPS ≥1 was significantly associated with longer survival outcomes in CLDN18.2-positive patients, and a tendency toward improved Nivo-OS in TROP2-positive patients.
This retrospective study included patients with AGC who had received systemic chemotherapy, with the primary objective of evaluating clinical outcomes in patients treated with nivolumab monotherapy after third-line therapy, by CLDN18.2 and TROP2 expression. The endpoints were overall survival after starting systemic chemotherapy and progression-free survival and overall survival after starting nivolumab monotherapy after third line treatment (Nivo-PFS and Nivo-OS, respectively).
The primary analysis included 69 patients treated with nivolumab monotherapy out of the 121 patients selected from the database. No significant difference in Nivo-PFS or Nivo-OS was found between the CLDN18.2-positive and CLDN18.2-negative populations or between the TROP2-positive and TROP2-negative populations. In the CLDN18.2-positive population, multivariable analysis showed that combined positive score (CPS) ≥1 was associated with significantly longer OS, Nivo-PFS, and Nivo-OS (p=0.03, p=0.03, p<0.01, respectively). In the TROP2-positive population, CPS ≥1 showed a tendency toward better prognosis for Nivo-OS (p=0.31) in the multivariable analysis.
Among patients undergoing nivolumab treatment, CPS ≥1 was significantly associated with longer survival outcomes in CLDN18.2-positive patients, and a tendency toward improved Nivo-OS in TROP2-positive patients.
Authors
Awatsu Awatsu, Kadono Kadono, Shoji Shoji, Hirose Hirose, Hirano Hirano, Okita Okita, Takashima Takashima, Nagahara Nagahara, Kato Kato
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