摘要 : For patients diagnosed with advanced gastric or gastroesophageal cancer that is not amenable to surgical intervention, the standard of care for first -line treatment consists of fluoropyrimidine and platinum -based chemotherapy. T... 展开 For patients diagnosed with advanced gastric or gastroesophageal cancer that is not amenable to surgical intervention, the standard of care for first -line treatment consists of fluoropyrimidine and platinum -based chemotherapy. The incorporation of novel agents into these standard first -line regimens could potentially improve patient prognosis; options for such augmentations include both immune -based and targeted therapy combinations. To provide a comparative analysis of these different first -line combination treatments, a network meta -analysis was conducted. Outcome measures comprised overall survival (OS), progression -free survival (PFS), objective response rate (ORR), and grade 3 -4 treatment -related adverse events (TRAEs). Data were drawn from 22 randomized controlled trials, encompassing 10,787 patients and 17 distinct treatment regimens. Our findings suggest that FGFR2b-targeted therapy, specifically when used in combination with chemotherapy (bemarituzumab_chemo), exhibited the greatest efficacy. This was followed by immunotherapy-based combination regimens (CPS >= 5, Sintilimab_chemo). Further, targeted combination therapy featuring CLAUDIN 18.2 (zolbetuximab_chemo) appeared beneficial based on individual patient characteristics. In the case of HER2positive patients, the trastuzumab_chemo regimen is recommended, as most existing studies have excluded this subpopulation. These results have significant implications for both clinical decision -making and patient care in the realm of advanced gastric or gastroesophageal cancer treatment. 收起