Abstract
OBJECTIVE: Programmed death-1 (PD-1) inhibitors combined with chemotherapy show certain clinical benefits in advanced gastric cancer patients, but more evidence is still needed. The present study aimed to investigate the efficacy and safety of PD-1 inhibitors combined with chemotherapy in these patients. METHODS: Forty-three patients with advanced gastric cancer receiving PD-1 inhibitors (including camrelizumab, sintilimab, and tislelizumab, 200 mg every 3 weeks) combined with chemotherapy were retrospectively enrolled. Data on treatment response, progression-free survival (PFS), and adverse reactions were collected. RESULTS: There were 1 (2.3%), 9 (20.9%), 32 (74.4%), and 1 (2.3%) patient who achieved complete response, partial response, stable disease, and progressive disease, respectively. The objective response rate and disease control rate were 23.3% and 97.7%. The 1- and 2-year cumulative PFS rates were 63.3% and 19.8%. The median PFS (95% confidence interval) was 13.5 (10.7–16.3) months. Higher Eastern Cooperative Oncology Group performance status score (per score) [hazard ratio (HR) = 5.404, P = 0.047] and higher maximum diameter of the lesion (per cm) (HR = 1.860, P = 0.048) independently predicted shorter PFS. The adverse reactions included hemoglobin decreased (76.7%; grade 3: 16.3%), white blood cells decreased (74.4%; grade 3: 7.0%), blood platelet decreased (25.6%; grade 3: 2.3%), white blood cells increased (9.3%; grade 3: none), and reactive cutaneous capillary endothelial proliferation (23.3%; grade 3: 2.3%). CONCLUSION: PD-1 inhibitors combined with chemotherapy may be an optional regimen for patients with advanced gastric cancer. However, the retrospective design and small sample size may limit the generalizability and robustness of our findings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-025-04207-0.