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Neoadjuvant chemoimmunotherapy has transformed the treatment of locally advanced gastric or gastroesophageal junction (G/GEJ) cancer. However, identifying reliable predictive markers for treatment efficacy remains challenging. We conducted a retrospective analysis to evaluate the prognostic value of peripheral blood regulatory T (Treg) cells in patients with G/GEJ cancer undergoing neoadjuvant chemoimmunotherapy followed by curative resection. From July 2020 to May 2023, 79 patients met the inclusion criteria. All patients achieved R0 resection following D2 radical surgery, with 26.6% exhibiting a pathological complete response (pCR). Significant differences in Treg cells, T/Treg ratios, and CD4+/Treg ratios were observed between patients with pCR and those without after one treatment cycle (P = 0.0054, 0.0489, and 0.0434, respectively). Patients were categorized based on changes in Treg cell counts post-treatment, revealing a higher pCR rate in those with reduced Treg cells (P = 0.014). Changes in Treg cell counts after one cycle of neoadjuvant chemoimmunotherapy serve as a promising predictive marker for pCR in locally advanced G/GEJ cancer patients. This finding supports the development of personalized treatment strategies, enhancing outcomes in this challenging clinical landscape.
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http://dx.doi.org/10.1038/s41598-025-14110-z | DOI Listing |
Front Public Health
September 2025
Department of Pharmacy, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China.
Background: Results from the GEMSTONE-303 trial indicate that compared with placebo plus capecitabine and oxaliplatin (PLA-CAP), sugemalimab plus capecitabine and oxaliplatin (SUG-CAP) as first-line therapy provides clinical benefits for patients with advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma with programmed cell death ligand 1 (PD-L1) combined positive score (CPS) ≥5. However, the addition of sugemalimab increases medical costs. This study aimed to assess the cost-effectiveness of SUG-CAP vs.
View Article and Find Full Text PDFBMC Cancer
August 2025
Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.
Background: Anti-programmed cell death-1 (PD-1) immunotherapy and platinum-based chemotherapy are key components of first-line treatment for advanced Gastric or Gastroesophageal Junction (G/GEJ) cancer. However, the role of immune cells infiltrating the tumor microenvironment (TME) in predicting both therapy responses is still unclear.
Methods: ORIENT-16 is a randomized, double-blind, placebo-controlled, phase 3 clinical trial, and enrolled 650 patients with unresectable locally advanced or metastatic G/GEJ cancer between January 3, 2019, and August 5, 2020.
J Clin Oncol
August 2025
Seoul National University College of Medicine, Seoul, Republic of Korea.
We report results of the final analysis of overall survival (OS) and patient-reported outcomes from the phase III KEYNOTE-585 (ClinicalTrials.gov identifier: NCT03221426) study. Participants with previously untreated, locally advanced, resectable gastric and gastroesophageal junction (G/GEJ) cancer were enrolled into the main (n = 804) and fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT; n = 203) cohorts, and randomly assigned 1:1 to neoadjuvant and adjuvant pembrolizumab plus chemotherapy or placebo plus chemotherapy.
View Article and Find Full Text PDFClin Pharmacokinet
August 2025
Astellas Pharma Global Development, Inc., Northbrook, IL, USA.
Zolbetuximab is a first-in-class chimeric (mouse/human) monoclonal antibody targeted to the tight junction protein claudin 18.2 (CLDN18.2), an emerging biomarker in gastric/gastroesophageal junction (G/GEJ) cancer.
View Article and Find Full Text PDFCells
August 2025
Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan.
Background: Anti-programmed death 1 receptor (PD-1) therapy is a promising treatment strategy for patients with unresectable advanced or recurrent gastric/gastroesophageal junction (G/GEJ) cancer. However, its response rate and survival benefits are still limited; an immunological analysis of the residual tumor after anti-PD-1 therapy would be important.
Methods: We evaluated the clinical efficacy of tumor resection (TR) after chemotherapy or anti-PD-1 therapy in patients with unresectable advanced or recurrent G/GEJ cancer and analyzed the immune status of tumor microenvironment (TME) by immunohistochemistry using their surgically resected specimens.