H pylori May Undermine Immunotherapy Response in Gastric Cancer
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Patients with advanced gastric cancer who have active Helicobacter pylori infections were less likely to respond to anti-PD-1 antibody therapy than H pylori–negative patients.
Those with active H pylori infections also demonstrated shorter progression-free survival (PFS) and overall survival (OS).
Why This Matters
Overall, patients with advanced gastric cancer do not respond well to immune checkpoint inhibitors.
Prognostic markers are needed to identify those patients who will and those who will not respond.
These findings suggest that active H pylori infection could be one such marker.
In this small retrospective study, investigators compared the response of advanced gastric cancer to anti-PD-1 antibodies in 34 patients who had active H pylori infections with that of 43 patients who did not.
Of the 77 patients, 43 received nivolumab, 29 received pembrolizumab, and five received camrelizumab/toripalimab/tislelizumab.
The H pylori–positive group had an almost threefold greater risk of nonclinical response (odds ratio [OR], 2.91).
The H pylori–negative group demonstrated longer median PFS (8.4 vs 2.7 months; hazard ratio [HR], 3.11) and OS (17.5 vs 6.2 months; HR, 2.85).
On multivariate regression, active H pylori infection was independently associated with shorter PFS (HR, 1.90) but not shorter OS (HR, 1.76; 95% CI, 0.99 – 3.12).
The study was a small, retrospective investigation.
Data on other prognostic factors — PD-L1 positivity, high microsatellite instability, and Epstein-Barr virus infection — were not included in the multivariate regression analysis.