Ibrahim Reyaz, MBBS1, Omer Farooq Mohammed, MBBS2, Binay Panjiyar, MD3, Chanpreet Singh, MD4, Sheenam Garg, MBBS5, Arghadip Das, MBBS6, Sai Nikhitha Malapati, MBBS7, Saif Syed, MD8, Aasim Akthar Ahmed, MD9, Priya Kumari Maheshwari, MD10, Mohammad Ali, MBBS11 1Nassau University Medical Center, East Meadow, NY; 2Osmania General Hospital and Medical College, Hyderabad, Telangana, India; 3NorthShore University Hospital, Manhasset, NY; 4South Texas Health System GME Consortium, McAllen, TX; 5Punjab Institute of Medical Sciences, Centreville, VA; 6Nilratan Sircar Medical College and Hospital, Kolkata, West Bengal, India; 7kamineni academy of medical sciences and research center, lb.nagar, hyderabad, india, Hyderabad, Telangana, India; 8Indiana University Health, Indiana, IN; 9St. Francis Medical Center, Monroe, LA; 10University of Central Florida, HCA Healthcare GME, Pensacola, FL; 11Kakatiya Medical College, Hyderabad, Telangana, India Introduction: Conventional therapies for gastric cancer, such as chemotherapy and radiation, offer limited survival benefits and are often associated with considerable toxicity. The emergence of monoclonal antibodies (mAbs) has introduced a targeted approach, enhancing anti-tumor effects while reducing collateral damage. They are designed to bind tumor-associated antigens, offering a personalized treatment. Clinical trials assessing these therapies commonly use overall survival (OS) and progression-free survival (PFS) as endpoints. OS measures time from treatment to death, while PFS reflects the time during which the disease does not progress. Methods: We conducted a systematic review following PRISMA 2020 guidelines. Searches were performed across PubMed, Google Scholar, Cochrane Library, PLOS One, Science Direct, and ClinicalTrials.gov for randomized controlled trials (RCTs) published between 2015 and May 2025. Search terms included combinations of “gastric cancer,” “monoclonal antibodies,” and “antineoplastic agents.” Studies were included if they reported OS and PFS outcomes of monoclonal antibodies. Four RCTs met the inclusion criteria. Results: In Boku et al., 2021, nivolumab demonstrated a significant OS benefit over placebo (5.3 vs 4.1 months) and a modest PFS benefit (1.61 vs 1.45 months). In Kong et al., 2024, inetetamab improved PFS compared to trastuzumab (8.5 vs 7.3 months, P = 0.046), but OS (15.4 vs 14.3 months) was not significantly different. Kang et al., 2024 reported that bemarituzumab plus mFOLFOX6 significantly improved both PFS (12.9 vs 8.2 months) and OS (24.7 vs 12.9 months) compared to placebo. In Qin et al., 2025, pembrolizumab plus chemotherapy led to improved OS (15.9 vs 12.2 months) and PFS (8.1 vs 5.7 months) versus placebo plus chemotherapy. Discussion: The integration of monoclonal antibodies and immune checkpoint inhibitors has transformed gastric cancer treatment. Trials show nivolumab improves OS modestly, with limited PFS benefit. Inetetamab significantly extends PFS over trastuzumab, though OS benefits remain unclear. Bemarituzumab combined with chemotherapy markedly improves both PFS and OS, highlighting the role of FGFR2b-targeted therapy. Pembrolizumab plus chemotherapy also significantly enhances survival outcomes. While traditional chemotherapy remains important, monoclonal antibodies are becoming essential for improving patient outcomes. Future studies should focus on refining combination strategies to maximize the benefits of these novel therapies.
Disclosures: Ibrahim Reyaz indicated no relevant financial relationships. Omer Farooq Mohammed indicated no relevant financial relationships. Binay Panjiyar indicated no relevant financial relationships. Chanpreet Singh indicated no relevant financial relationships. Sheenam Garg indicated no relevant financial relationships. Arghadip Das indicated no relevant financial relationships. Sai Nikhitha Malapati indicated no relevant financial relationships. Saif Syed indicated no relevant financial relationships. Aasim Akthar Ahmed indicated no relevant financial relationships. Priya Kumari Maheshwari indicated no relevant financial relationships. Mohammad Ali indicated no relevant financial relationships.
Ibrahim Reyaz, MBBS1, Omer Farooq Mohammed, MBBS2, Binay Panjiyar, MD3, Chanpreet Singh, MD4, Sheenam Garg, MBBS5, Arghadip Das, MBBS6, Sai Nikhitha Malapati, MBBS7, Saif Syed, MD8, Aasim Akthar Ahmed, MD9, Priya Kumari Maheshwari, MD10, Mohammad Ali, MBBS11. P2048 - Evaluating the Impact of Monoclonal Antibodies on Survival Outcomes in Advanced Gastric Cancer: A Systematic Review of RCTs, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
