![]() ![]() 1 A combination of fluoropyrimidines and platinum agents was the standard first-line treatment for human epidermal growth factor receptor 2 (HER2)-negative advanced gastric cancer (AGC), 2–4 and the combination of nivolumab is now added to the standard first-line treatment. Gastric cancer, including gastro-esophageal junction cancer, is the fifth most reported cancer type and the fourth leading cause of cancer-related deaths worldwide. Keywords: immune checkpoint inhibitors, chemotherapy, programmed cell death-1, human epidermal growth factor receptor 2 Thus, this review summarized the clinical trials of chemotherapy plus anti-PD1 antibody as a first-line treatment and focused on the role of nivolumab combined with chemotherapy mainly from the viewpoint of the Japanese experience. However, the approval requirements and recommendations are different according to the approval agent or country. Based on these results, chemotherapy plus nivolumab in a first-line treatment was approved worldwide. Recently, chemotherapy plus nivolumab, as a first-line treatment for AGC, showed both OS and progression-free survival (PFS) benefits in patients with PD-L1 combined positive score (CPS) ≥ 5 in the global CheckMate-649 trial, and demonstrated PFS benefit irrespective of CPS status in the Asian ATTRACTION-4 trial. Nivolumab, a monoclonal anti-PD-1 antibody, firstly showed an improvement in the overall survival (OS) in patients with AGC in the ATTRACTION-2 trial. *These authors contributed equally to this workĬorrespondence: Kohei Shitara, Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan, Tel +81-4-7133-1111, Fax +81-4-7134-6865, Email Ībstract: Recently, immune checkpoint inhibitor (ICI), such as anti-programmed cell death-1 (PD-1) or programmed cell death ligand-1 (PD-L1) monoclonal antibodies, has provided clinical benefits in various cancer types including advanced gastric cancer (AGC). ![]() Marianna University School of Medicine, Kawasaki, Kanagawa, Japan Yohei Kubota 1, 2 *, Yu Aoki 1 *, Akihito Kawazoe, 1 Kohei Shitara 1ġDepartment of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan 2Department of Clinical Oncology, St. ![]()
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