There have been rising incidences of gastric cancer on a global scale. As a result, this cancer is now considered the fourth leading oncological cause of death worldwide. Gastric cancer often fails to show symptoms in early stages, leading to late-stage diagnosis and poorer prognoses. Research centers around improving diagnostic measures, as well as improving therapeutic options for patients. In an article from Emily Kimber in PMLive, findings from the Phase 3 KEYNOTE-859 study highlight the benefits of Keytruda, in conjunction with chemotherapy, for patients with HER2-negative locally advanced unresectable or metastatic gastric cancer or gastroesophageal junction carcinoma.

Within this study, researchers sought to understand the safety, efficacy, and tolerability of Keytruda and either fluoroyrimidine-containing chemotherapy or platinum-containing chemotherapy. Altogether, 1,579 participants enrolled. The researchers evaluated chemotherapy in conjunction with Keytruda, as well as chemotherapy as a monotherapy. The National Cancer Institute (NCI) describes Keytruda as:

A drug that binds to the protein PD-1 to help immune cells kill cancer cells better and is used to treat many different types of cancer. These include cancers that express the protein PD-L1, that have certain mutations (changes) in genes involved in DNA repair, or that have a high number of tumor mutations.

Keytruda reduced the risk of disease progression by 24% and the risk of death by 22%. The treatment was shown to significantly improve overall survival rate. Additionally, Keytruda showed a longer response duration than chemotherapy as its own agent. This data highlights the potential of improving gastric cancer treatment and outcomes through a dual approach.

Gastric Cancer: What Is It?

Also known as stomach cancer, gastric cancer occurs when cancerous cells form in the stomach lining. It often begins in cells lining the inner (mucosal) layer before spreading outwards into the middle (muscularis) and outer (serosal) layers. There are multople forms of stomach cancer: lymphoma, adenocarcinoma, stromal tumors, carcinoid tumors, leiomyosarcoma, squamous cell carcinoma, and small cell carcinoma. This cancer is more common in older individuals (aged 65+) and males. Additional risk factors include obesity, smoking cigarettes, a family history of gastric cancer, H. pylori infection, gastroesophageal reflux disease (GERD), and eating a high sodium but low fruit/vegetable diet. When symptoms appear, these may include:

• Severe and chronic heartburn and indigestion
• Dysphagia (difficulty swallowing)
• Appetite loss
• Stomach pain
• Bloody stool
• Jaundice (yellowing of the skin, eyes, and mucous membranes)
• Feeling full or bloated after eating, even with small portions
• Persistant nausea and vomiting, which may include vomiting up solid food shortly after eating
• Unintended weight loss
• Fatigue