Prognostic and Predictive Value of Microsatellite Instability, Inflammatory Reaction and PD-L1 in Gastric Cancer Patients Treated with Either Adjuvant 5-FU/LV or Sequential FOLFIRI Followed by Cisplatin and Docetaxel: A Translational Analysis from the ITACA-S Trial.
Maria Di BartolomeoFederica MoranoAlessandra RaimondiRosalba MiceliSalvatore CoralloElena TamboriniFederica PerroneMaria AntistaMonica NigerAlessandro PellegrinelliGiovanni RandonFilippo PaganiAntonia MartinettiGiovanni FucàFilippo Pietrantonionull nullPublished in: The oncologist (2019)
In this post hoc analysis of patients with radically resected gastric cancer randomized to an intensive sequential chemotherapy regimen versus 5-FU/LV monotherapy as adjuvant treatment in the ITACA-S trial, MSI-high status was independently associated with better disease-free survival and overall survival (OS) and inflammatory reaction was independently associated with better OS. Moreover, tumor PD-L1 expression ≥1% was associated with greater benefit from intensive sequential chemotherapy compared with 5-fluorouracil plus leucovorin (5-FU/LV), whereas PD-L1 expression <1% was not, conditioning a statistically significant interaction between such biomarker and treatment arms. The meta-analysis of individual patients' data from available studies could yield data on the role of MSI status that could inform clinical decisions.
Keyphrases
- free survival
- phase iii
- open label
- early stage
- phase ii
- clinical trial
- study protocol
- end stage renal disease
- electronic health record
- newly diagnosed
- oxidative stress
- combination therapy
- ejection fraction
- prognostic factors
- big data
- double blind
- machine learning
- chronic kidney disease
- placebo controlled
- data analysis