Effect and Safety of PD-(L)1 Inhibitors in Gastrointestinal Malignancies: Meta-analysis

ObjectiveThe effects of PD-(L)1 inhibitors on immediate and long-term prognosis, solid tumor response, and adverse effects in the treatment of advanced gastroesophageal cancer were summarized and analyzed, thus identifing the advantages of PD-(L)1 inhibitors over conventional chemotherapy, and better guiding the clinical treatment of gastroesophageal cancer.MethodsThe PubMed, EMBASE, Cochrane, Google, and CNKI databases were searched for relevant literature related to PD-(L)1 inhibitors for gastroesophageal cancer published before August 2023. Summary analyses of immediate and distant OS and PFS, solid tumor response (ORR, DCR, and DOR), and adverse events in the PD-(L)1 inhibitor intervention group were performed, and the SMD or OR of 95% CI was calculated by Review Manager.ResultsEleven studies with 5444 patients were enrolled in this meta-analysis with a low to moderate total risk of bias. OS and PFS of patients in the PD-(L)1 inhibitor group were markedly higher than those in the chemotherapy group at 6, 12, and 24 months, as well as the levels of ORR, DCR, and DOR. In addition, PD-(L)1 inhibitors did not markedly increase adverse reaction rate during treatment, but attention should be paid to the occurrence of immune-related adverse events.ConclusionPD-(L)1 inhibitors can better and consistently reduce the tumor diameter of gastroesophageal cancer and effectively improve the immediate and long-term prognosis of patients. In addition, the safety profile of PD-(L)1 inhibitors is assured.