Treatment of advanced gastric cancer and position of immune checkpoint inhibitors

Jeiran Haghighi,1,* Mohammad amin dehghani ,2 Afarin aghajari,3 Bahareh taati,4

Abstract


Introduction

advanced gastric cancer immunotherapy has been susceptible to change following the use of checkpoint blockers. some of the therapies for the advanced gastric cancer are monoclonal antibodies targeted against the immune checkpoint molecules of cytotoxic t-lymphocyte-associated protein 4 (ctla-4), programmed death protein 1 (pd-1) and programmed cell death protein ligand-1 (pdl1).

Methods

The search strategy was implemented on pubmed database in english using the keywords of advanced gastric; immune checkpoint inhibitors; anti-pd-1; anti-ctla-4and treatment.

Results

during small nonrandomized trials, 10% to 20% of patients with gastric cancer showed objective responses induced by pdl1 antibodies alone or in combination with ctla-4. the us fda approved pembrolizumab as monoclonal antibody against pd-1 in treating the patients with pd-l1+ advanced gastric cancer progressed on at least two prior lines of chemotherapy. tremelimumab, a kind of igg2 monoclonal antibody, is able to impede ctla 4 receptor. the objective response rate (orr) of 18 patients was only 5% and the median overall survival (os) was 4.8 months in evaluating tremilimumab ii stage in second-line treatment of advanced gastric cancer.

Conclusion

The anti-tumor immunity can be liberated and durable cancer regressions cane be occurred by the immune checkpoint-interrupting drugs, including anti-ctla-4, anti-pd-1, anti-pd-l1, and others in early stages. the advanced immunotherapy of gastric cancer has been recently progressed thanks to immune checkpoints such as ctla-4 and pd-1, suggesting newly developed strategies of immunotherapies in treating the advanced gastric cancer.

Keywords

Advanced gastric; immune checkpoint inhibitors; anti-pd-1; anti-pdl1; anti-ctla-4; treatment.