PD-(L)1 Inhibitors Plus Chemotherapy in Advanced Gastric Cancer: CGH | July 2026

Introduction:

Immune checkpoint inhibitors combined with chemotherapy have become the standard first-line treatment for advanced HER2-negative gastric and gastroesophageal junction cancers. This meta-analysis evaluated whether treatment benefits differ between Asian and non-Asian populations.

Why was this study needed?

Gastric cancer differs across geographic regions in terms of incidence, biology, and clinical practice. Whether these differences influence the efficacy and safety of first-line PD-(L)1 inhibitor-based therapy has remained uncertain.

What did the study show?

• Seven phase III randomized trials involving more than 6,700 patients were included.
• PD-(L)1 inhibitors plus chemotherapy significantly improved overall survival compared with chemotherapy alone.
• Progression-free survival was also significantly prolonged with chemoimmunotherapy.
• Survival benefits were consistent in both Asian and non-Asian patients, with comparable treatment effects across regions.
• Treatment-related adverse events were similar between chemoimmunotherapy and chemotherapy alone.
• The findings support the generalizability of first-line PD-(L)1 inhibitor therapy regardless of geographic region.

Clinical Impact:

This analysis confirms that the survival benefit of adding PD-(L)1 inhibitors to chemotherapy is not restricted to a particular ethnic or regional population. These data reinforce current global recommendations supporting chemoimmunotherapy as first-line treatment for eligible patients with advanced HER2-negative gastric and gastroesophageal junction cancer.

Take-Home Message:

First-line PD-(L)1 inhibitor plus chemotherapy provides a consistent survival benefit for advanced gastric and gastroesophageal junction cancer in both Asian and non-Asian populations, supporting its worldwide use as a standard-of-care treatment.