Efficacy of first-line immunochemotherapy by PD-L1 in HER2-negative gastric or gastroesophageal junction cancer: A meta-analysis

Tong Xie; Xiaotian Zhang; Zhi Peng; Yakun Wang; Lin Shen

doi:10.59717/j.xinn-oncol.2026.100030

The Innovation Oncology > 2026 Vol. 1 > No. 2 > 100030

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Efficacy of first-line immunochemotherapy by PD-L1 in HER2-negative gastric or gastroesophageal junction cancer: A meta-analysis

1.
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Cell & Gene Therapy for Solid Tumor, Department of GI Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
2.
Peking University Cancer Hospital (Inner Mongolia Campus)/Affiliated Cancer Hospital of Inner Mongolia Medical University, Inner Mongolia Cancer Center, Hohhot 010020, China

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Corresponding author: shenlin@bjmu.edu.cn
Received Date: June 11, 2026

Accepted Date: July 15, 2026

Published Online: July 24, 2026

The Innovation Oncology 1(2), https://doi.org/10.59717/j.xinn-oncol.2026.100030 | Cite this article

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1. This meta-analysis compared immunochemotherapy versus chemotherapy in HER2-negative gastric cancer.
  
  7 monoclonal antibody trials were primary analysis, with two bispecific antibody trials as exploratory.
  
  Patients with PD-L1 CPS ≥1 showed significant survival benefit, while CPS <1 patients did not benefit.
  
  Chinese patients achieved greater benefits in OS/PFS than the global population.
  
  CPS ≥1 may serve as a practical cutoff for selecting first-line PD-1/PD-L1 antibody plus chemotherapy.

ABSTRACT

ABSTRACT

Identifying optimal PD-L1 expression cutoff thresholds to guide programmed cell death protein-1/programmed death ligand-1 (PD-1/PD-L1) antibody combined with chemotherapy for patients with advanced HER2-negative gastric or gastroesophageal junction adenocarcinoma (GC/GEJC) remains a major challenge in clinical decision-making. This meta-analysis included nine randomized controlled trials of immunochemotherapy versus chemotherapy in patients with HER2-negative GC/GEJC; eight trials included Chinese patients. Among the global population, PD-1/PD-L1 antibodies plus chemotherapy significantly reduced mortality risk versus chemotherapy, with a positive association between CPS and overall survival (OS) benefit (CPS ≥1: HR_OS 0.75, 95% CI 0.70–0.80; CPS ≥5: HR_OS 0.70, 95% CI 0.64–0.76 and CPS ≥10: HR_OS 0.67, 95% CI 0.61–0.73; all p<0.0001 vs. chemotherapy), and an OS benefit for intermediate CPS cutoffs (1–4, 1–9, 5–9, <5 and <10). A similar trend was observed for progression-free survival (PFS). The OS and PFS benefits in Chinese patients were numerically greater versus the global population. Patients with CPS <1 did not benefit from immunochemotherapy. In conclusion, CPS ≥1 may be a clinically actionable cutoff for selecting PD-1/PD-L1 monoclonal antibody combined with chemotherapy in patients with HER2-negative GC/GEJC and Chinese patients derived a modestly greater OS and PFS benefit from that versus the global population. Analyses including studies of bispecific antibodies showed consistent results with those only including PD-1/PD-L1 antibodies.
- immunochemotherapy /
- programmed death-ligand 1 /
- combined positive score /
- gastric cancer /
- gastroesophageal junction cancer /
- meta-analysis

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Xie T., Zhang X., Peng Z., et al. (2026). Efficacy of first-line immunochemotherapy by PD-L1 in HER2-negative gastric or gastroesophageal junction cancer: A meta-analysis. The Innovation Oncology 1:100030. https://doi.org/10.59717/j.xinn-oncol.2026.100030

Xie T., Zhang X., Peng Z., et al. (2026). Efficacy of first-line immunochemotherapy by PD-L1 in HER2-negative gastric or gastroesophageal junction cancer: A meta-analysis. The Innovation Oncology 1:100030. https://doi.org/10.59717/j.xinn-oncol.2026.100030

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Efficacy of first-line immunochemotherapy by PD-L1 in HER2-negative gastric or gastroesophageal junction cancer: A meta-analysis

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