Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.106361
Revised: March 28, 2025
Accepted: May 13, 2025
Published online: June 27, 2025
Processing time: 94 Days and 18 Hours
Gastric cancer is a leading global cause of cancer mortality, with poor survival in locally advanced stages. While immune checkpoint inhibitors (ICIs) like sintilimab have improved outcomes in advanced disease, their role as neoadjuvant therapy remains understudied. This study investigates sintilimab combined with nab-paclitaxel/S-1 as preoperative treatment for locally advanced gastric cancer (LAGC), addressing an unmet need for effective neoadjuvant strategies.
To explore the efficacy and safety of combination treatment with sintilimab and nab-paclitaxel plus S-1 as neoadjuvant therapy for LAGC.
Clinical data from 82 patients diagnosed with LAGC, who underwent preo
Imaging evaluation of therapeutic efficacy revealed that the inclusion of ICI yielded a significantly higher complete response rate (13.2% vs 0.0%; P = 0.048), and objective response rate (69.8% vs 31.0%, P = 0.001) compared with non-ICI treatment. Pathological evaluation revealed that the ICI group exhibited a significantly higher pathological complete response rate (13.2% vs 0.0%; P = 0.048) and major pathological response rate (35.8% vs 13.8%; P = 0.041) than those in the non-ICI group. The two-year disease-free survival rate in the ICI group was greater than that in the non-ICI group (83.0% vs 55.2%; P = 0.043). The use of ICI did not increase the incidence of adverse reactions (47.2% vs 41.4%; P = 0.614) or perioperative adverse events (18.9% vs 13.8%; P = 0.761).
The combination of sintilimab with nab-paclitaxel + S-1 for neoadjuvant treatment of LAGC improved efficacy in patients without increasing adverse drug reactions and perioperative adverse events, suggesting that this treatment regimen is safe and feasible.
Core Tip: This study investigated sintilimab (an immune checkpoint inhibitor) plus nab-paclitaxel and S-1 as neoadjuvant therapy for locally advanced gastric cancer. The combination significantly improved pathological complete response and major pathological response rates, while also demonstrating superior 2-year disease-free survival compared to chemotherapy alone, without additional safety concerns. These findings support its potential as an effective preoperative treatment strategy for locally advanced gastric cancer.