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Sintilimab Combined With Chemotherapy Improves Outcomes in Advanced Gastroesophageal CancerImmunotherapy combined with chemotherapy improves survival for gastroesophageal cancer

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Key Takeaway
Sintilimab plus chemotherapy improves survival and progression-free rates in advanced gastroesophageal cancer.

This meta-analysis evaluated the efficacy of PD-1 inhibitors in patients with advanced unresectable gastroesophageal cancer. The study compared the combination of immunotherapy and chemotherapy against standard single-agent chemotherapy regimens to determine clinical outcomes.

Results indicated that patients receiving the dual therapy experienced superior overall survival and progression-free survival compared to those receiving chemotherapy alone. Furthermore, sintilimab specifically demonstrated higher efficacy when paired with chemotherapy than other PD-1 inhibitor-based regimens.

Safety profiles for the combination therapy showed manageable adverse events. While the addition of immunotherapy increased the frequency of treatment-related adverse events, sintilimab specifically did not increase these rates in indirect comparisons. These findings suggest a viable first-line treatment strategy.

Despite the positive outcomes, the study notes that the safety and efficacy of sintilimab were assessed via indirect comparisons. Clinical application should consider these limitations while acknowledging the improved prognosis for patients receiving the combined regimen.

How this fits prior evidence

This meta-analysis extends the finding that PD-1/PD-L1 inhibitor plus chemotherapy improves overall survival in advanced gastric and esophageal junction cancer. It specifically adds evidence that sintilimab combined with chemotherapy may show more efficacy than other PD-1 inhibitor-based regimens in advanced unresectable gastroesophageal cancer. While it confirms the superiority of immunotherapy combinations over single-agent chemotherapy, the specific efficacy of sintilimab is based on indirect comparisons.

Living with advanced gastroesophageal cancer means facing a difficult road ahead. For patients whose tumors cannot be removed by surgery, finding a treatment that works effectively is vital. New data suggests that adding immunotherapy to a standard chemotherapy regimen can improve both the length of time patients live and the time they live without their cancer progressing.

Researchers looked at data from over 6,600 patients to compare these treatments. They found that the combination of immunotherapy and chemotherapy performed better than using chemotherapy by itself. Specifically, the study looked at a type of immunotherapy called a PD-1 inhibitor. Among these options, a specific drug called sintilimab showed more efficacy when paired with chemotherapy than other similar treatments.

While the combination treatment can cause more side effects than chemotherapy alone, these effects were described as manageable. However, it is important to note that the specific data regarding sintilimab's safety and success came from indirect comparisons. Because of this, the evidence for that specific drug is less certain than other parts of the study.

What this means for you:
Combining immunotherapy with chemotherapy improves survival for patients with advanced gastroesophageal cancer.

Common questions

How does immunotherapy combined with chemotherapy compare to chemotherapy alone?

For patients with advanced gastroesophageal cancer, combining immunotherapy with chemotherapy improves overall survival and progression-free survival compared to using chemotherapy alone. This means patients may live longer and have more time before the cancer begins to spread or worsen.

What is sintilimab and how does it perform?

Sintilimab is a type of PD-1 inhibitor, which is a class of immunotherapy. When combined with chemotherapy, sintilimab showed more efficacy than other PD-1 inhibitor-based regimens for patients with advanced gastroesophageal cancer.

Are there side effects to this combination treatment?

The combination of immunotherapy and chemotherapy can lead to more side effects than chemotherapy alone. However, these effects were described as manageable. For the specific drug sintilimab, the data on safety and efficacy were based on indirect comparisons.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
ObjectiveThe FDA approval of immune checkpoint inhibitors for advanced gastroesophageal cancer (GEC) independent of programmed death-ligand 1 (PD-L1) expression status has sparked notable clinical controversy, highlighting the urgent need for evidence-based evaluation of the efficacy and safety of various PD-1 inhibitors combinations for this malignancy.MethodsWe followed the pre-registered PROSPERO protocol (CRD42022325401) to search the databases and conferences. The primary outcomes included overall survival (OS), progression-free survival (PFS), and treatment-related adverse event (TRAE). A random-effects model was applied for meta-analysis, with statistical data analysis performed using Review Manager software and the distribution of adverse event (AE) subtypes visualized via R software.ResultsA total of 6625 patients from 9 phase III randomized controlled trials (RCTs) were ultimately included in this analysis. The overall risk of included RCTs was low. Results found immunotherapy combined with chemotherapy improved patients’ prognosis more than single-agent chemotherapy, with corresponding increased but manageable adverse effects. Subgroup analyses by drug type further revealed that sintilimab in combination with chemotherapy exhibited more efficacy than other PD-1 inhibitor-based regimens. The survival benefit in the immunotherapy combined with chemotherapy group compared to chemotherapy alone was seen in both PD-L1 CPS positive and TPS positive. The evidence strength was moderate.ConclusionFindings from this comprehensive study confirm that immunotherapy combined with chemotherapy is more efficacious than traditional chemotherapy in the first-line treatment of patients with advanced unresectable GEC. Sintilimab combined with chemotherapy demonstrated favorable efficacy and safety profiles compared with other PD-1 therapies in terms of OS and PFS benefit without increasing TRAE base on indirect comparisons. The moderate evidence indicated PD-1 combined with chemotherapy may be a viable option for advanced unresectable GEC.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022325401.
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