COMPARATIVE EFFICACY AND SAFETY OF REGIMENS FOR PRETREATED GASTRIC OR GASTROESOPHAGEAL JUNCTION CANCER: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS
Author(s)
Yvyang Zhang, MSc1, Jiayi Zhang, MSc1, Wenhui Fan, MSc1, Meixuan Li, PhD2, Shitong Xie, PhD1.
1School of Pharmaceutical Science and Technology, Faculty of Medicine, Tianjin University, Tianjin, China, 2Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
1School of Pharmaceutical Science and Technology, Faculty of Medicine, Tianjin University, Tianjin, China, 2Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
OBJECTIVES: This study performed a network meta-analysis (NMA) to evaluate the comparative efficacy and safety of different regimens for patients with previously treated (second-line and beyond) locally advanced, recurrent, or metastatic gastric or gastroesophageal junction (G/GEJ) cancer.
METHODS: A systematic review and frequentist NMA based on a random-effects model was performed. A systematic search was conducted in Embase, Web of Science, Medline and CINAHL databases up to March 10, 2026 to identify eligible clinical trials assessing regimens for individuals with advanced G/GEJ cancer who progressed after at least one prior line of systemic therapy. The primary outcomes were progression-free survival (PFS) and overall survival (OS). This study was conducted using R software to calculate pooled effect estimates with 95% confidence intervals (CIs) for all outcomes. Study selection, data extraction, and quality assessment were performed independently by two reviewers, with discrepancies resolved by a third reviewer. This study was registered with PROSPERO (CRD 420261326355).
RESULTS: Of 6,486 studies retrieved, 23 were included in our study. Compared with chemotherapy, the top-ranked PFS regimens were anbenitamab plus chemotherapy (HR, 0.25; 95% CI, 0.17-0.38; P-score, 0.982), camrelizumab plus chemotherapy (HR, 0.33; 95% CI, 0.14-0.77; P-score, 0.925), and trastuzumab deruxtecan (HR, 0.50; 95% CI, 0.40-0.62; P-score, 0.871). For OS, anbenitamab plus chemotherapy (HR, 0.29; 95% CI, 0.17-0.50; P-score, 0.994), trastuzumab deruxtecan (HR, 0.61; 95% CI, 0.48-0.76; P-score, 0.859), and camrelizumab plus chemotherapy (HR, 0.62; 95% CI, 0.35-1.09; P-score, 0.779) ranked highest. For HER2-positive patients, anbenitamab-based regimens achieved the top efficacy across 4 assessed regimens. Trastuzumab deruxtecan was associated with higher risks of both TEAEs and TRAEs than anbenitamab plus chemotherapy and chemotherapy. Anbenitamab plus chemotherapy showed the greatest consistency in P-score values for PFS, OS, and safety.
CONCLUSIONS: Anbenitamab plus chemotherapy showed the most favourable efficacy outcomes, with acceptable toxicity, among evaluated regimens for advanced G/GEJ cancer.
METHODS: A systematic review and frequentist NMA based on a random-effects model was performed. A systematic search was conducted in Embase, Web of Science, Medline and CINAHL databases up to March 10, 2026 to identify eligible clinical trials assessing regimens for individuals with advanced G/GEJ cancer who progressed after at least one prior line of systemic therapy. The primary outcomes were progression-free survival (PFS) and overall survival (OS). This study was conducted using R software to calculate pooled effect estimates with 95% confidence intervals (CIs) for all outcomes. Study selection, data extraction, and quality assessment were performed independently by two reviewers, with discrepancies resolved by a third reviewer. This study was registered with PROSPERO (CRD 420261326355).
RESULTS: Of 6,486 studies retrieved, 23 were included in our study. Compared with chemotherapy, the top-ranked PFS regimens were anbenitamab plus chemotherapy (HR, 0.25; 95% CI, 0.17-0.38; P-score, 0.982), camrelizumab plus chemotherapy (HR, 0.33; 95% CI, 0.14-0.77; P-score, 0.925), and trastuzumab deruxtecan (HR, 0.50; 95% CI, 0.40-0.62; P-score, 0.871). For OS, anbenitamab plus chemotherapy (HR, 0.29; 95% CI, 0.17-0.50; P-score, 0.994), trastuzumab deruxtecan (HR, 0.61; 95% CI, 0.48-0.76; P-score, 0.859), and camrelizumab plus chemotherapy (HR, 0.62; 95% CI, 0.35-1.09; P-score, 0.779) ranked highest. For HER2-positive patients, anbenitamab-based regimens achieved the top efficacy across 4 assessed regimens. Trastuzumab deruxtecan was associated with higher risks of both TEAEs and TRAEs than anbenitamab plus chemotherapy and chemotherapy. Anbenitamab plus chemotherapy showed the greatest consistency in P-score values for PFS, OS, and safety.
CONCLUSIONS: Anbenitamab plus chemotherapy showed the most favourable efficacy outcomes, with acceptable toxicity, among evaluated regimens for advanced G/GEJ cancer.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
CO4
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Oncology