{
  "abstract": "Background: Chemo-immunotherapy (CIT) has become the frontline therapy for advanced human epidermal growth factor receptor 2 (HER2)-negative gastric or gastro-esophageal junction adenocarcinoma (GEAC). However, emerging evidence suggests that clinical benefit is primarily derived from patients with a high combined positive score (CPS), whereas the efficacy of CIT among different CPS intervals remained unknown.\n\nMethods: A systemic literature search was performed to screen for RCTs studying addition of PD-1/PD-L1 inhibitors to chemotherapy versus chemotherapy alone in metastatic GEAC with efficacy information across different CPS interval. Pooled analysis of hazard ratios (HRs) for overall survival (OS), progression free survival (PFS), odds ratios (ORs) for objective response rate (ORR) and heterogeneity analysis on treatment efficacy were performed in CPS < 1, 1 ~ 4, 5 ~ 9, ≥10 subgroups.\n\nResults: The analysis showed that adding programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) inhibitors to ChT significantly improved overall survival (OS) in the CPS ≥ 10 subgroup (hazard ratio [HR], 0.67 [95%CI 0.61–0.73]), but not in the CPS < 1 or 5–9 subgroups; only a marginal benefit was observed in the CPS 1–4 subgroup. CPS ≥ 10 vs <10 presented the strongest interaction effect between CPS and the efficacy of adding PD-1/PD-L1 inhibitors to ChT (Pinteraction < 0.0001). Additionally, CIT significantly improved the progression-free survival (PFS) and objective response rate (ORR) in both CPS-low (CPS < 1: HR, 0.85 [95%CI 0.72–1.00]; odds ratio [OR], 1.41 [95%CI 1.02–1.96]) and CPS-high (CPS ≥ 10: HR, 0.64 [95%CI 0.58–0.70]; OR, 1.87 [95%CI 1.50–2.33]) subgroups versus ChT alone.\n\nConclusions: CPS ≥ 10 defines a subgroup deriving the greatest benefit from CIT, supporting its use as a clinically informative threshold for PD-1 inhibitor therapy in advanced GEAC. Nevertheless, patients with CPS < 10 may still gain benefit from CIT when tumor shrinkage is the primary treatment objective.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060 China",
    "Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, 510060 P. R. China",
    "Department of Anesthesiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060 China",
    "Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080 China",
    "Department of Clinical Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060 China",
    "Faculty of Medical Science, Jinan University, 601 Huangpu Avenue West, Guangzhou, 510630 China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Yu-Kun Chen"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Wen-Wei Wu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Fan Chen"
    },
    {
      "affs": [
        3
      ],
      "name": "Lan-Jie Chen"
    },
    {
      "affs": [
        0,
        1,
        4
      ],
      "name": "Hao-Xiang Wu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ying-Nan Wang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ying Jin"
    },
    {
      "affs": [
        5
      ],
      "name": "Yu-Tong Chen"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Zi-Xian Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3ea1rhfsb77fv.bib",
  "cited_by": 0,
  "doi": "10.1186/s12916-026-05124-z",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13737756/",
  "id": "3ea1rhfsb77fv",
  "issns": [
    "1741-7015"
  ],
  "landing_url": "https://doi.org/10.1186/s12916-026-05124-z",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2730|Cancer Immunotherapy and Biomarkers"
    ]
  ],
  "openalex": "W7201957492",
  "pdf_url": null,
  "pmcid": "PMC13737756",
  "pmid": "42983403",
  "published": "2026-08-08",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/3ea1rhfsb77fv.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:22:52Z",
      "native_id": "PMC13737756",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12916-026-05124-z"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Cancer Immunotherapy and Biomarkers",
      "subfield": "oncology"
    }
  ],
  "title": "Efficacy of anti-PD-1/PD-L1 plus chemotherapy in treatment-naïve advanced HER2-negative gastric adenocarcinoma among different PD-L1 intervals: an updated meta-analysis and reconstructed individual patient-level data analysis",
  "title_text": "Efficacy of anti-PD-1/PD-L1 plus chemotherapy in treatment-naïve advanced HER2-negative gastric adenocarcinoma among different PD-L1 intervals: an updated meta-analysis and reconstructed individual patient-level data analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:22:52Z",
  "url": "https://research.draconitic.com/paper/3ea1rhfsb77fv",
  "venue": "BMC Medicine",
  "versions": []
}