Title: Efficacy and Safety of Nivolumab in Advanced Gastric and Gastroesophageal Junction
Cancer: A Meta-Analysis of Randomized Controlled Trials
Version: 1 Date: 28 Aug 2024
Reviewer:  Toshimitsu Tanaka
Reviewer's report:
In a meta-analysis, the authors found prolonged OS and PFS with nivolumab treatment for
advanced gastric cancer and esophagogastric junction cancer. They also found that adverse
events were more common with nivolumab treatment. The author has a serious problem that
needs to be resolved before publication.
Regarding the trials extracted in the meta-analysis of the current study, all four trials extracted
for Nivolumab vs placebo are the ATTRACTION-2 trial, a phase III trial. Subgroup analyses
and long-term follow-ups are included, but all the same trials are extracted. In addition, five
studies were selected for Nivolumab+chemotherapy vs. chemotherapy: three studies from the
phase III CheckMate 649 trial and two studies from the phase II and III ATTRACTION-4 trials.
In other words, the extracted trials are the results of long-term follow-ups and subgroup analyses
of almost the same clinical trials. Therefore, if it is Nivolumab alone, only the results of the
ATTRACTION-2 trial are being looked at. Furthermore, if it is Nivolumab plus chemotherapy,
there are only two trials, the CheckMate649 trial and the ATTRACTION-4 trial. With these
results, I think it is hard to call it a meta-analysis analysis. At least concerning nivolumab
monotherapy, it is the same clinical trial.
Title: Efficacy and Safety of Nivolumab in Advanced Gastric and Gastroesophageal Junction
Cancer: A Meta-Analysis of Randomized Controlled Trials
Version: 1 Date: 28 Aug 2024
Reviewer:  Toshimitsu Tanaka
Reviewer's report:
In a meta-analysis, the authors found prolonged OS and PFS with nivolumab treatment for
advanced gastric cancer and esophagogastric junction cancer. They also found that adverse
events were more common with nivolumab treatment. The author has a serious problem that
needs to be resolved before publication.
Regarding the trials extracted in the meta-analysis of the current study, all four trials extracted
for Nivolumab vs placebo are the ATTRACTION-2 trial, a phase III trial. Subgroup analyses
and long-term follow-ups are included, but all the same trials are extracted. In addition, five
studies were selected for Nivolumab+chemotherapy vs. chemotherapy: three studies from the
phase III CheckMate 649 trial and two studies from the phase II and III ATTRACTION-4 trials.
In other words, the extracted trials are the results of long-term follow-ups and subgroup analyses
of almost the same clinical trials. Therefore, if it is Nivolumab alone, only the results of the
ATTRACTION-2 trial are being looked at. Furthermore, if it is Nivolumab plus chemotherapy,
there are only two trials, the CheckMate649 trial and the ATTRACTION-4 trial. With these
results, I think it is hard to call it a meta-analysis analysis. At least concerning nivolumab
monotherapy, it is the same clinical trial.
Please review this paper.
user
Title: Efficacy and Safety of Nivolumab in Advanced Gastric and Gastroesophageal Junction
Cancer: A Meta-Analysis of Randomized Controlled Trials
Version: 1 Date: 28 Aug 2024
Reviewer:  Toshimitsu Tanaka
Reviewer's report:
In a meta-analysis, the authors found prolonged OS and PFS with nivolumab treatment for
advanced gastric cancer and esophagogastric junction cancer. They also found that adverse
events were more common with nivolumab treatment. The author has a serious problem that
needs to be resolved before publication.
Regarding the trials extracted in the meta-analysis of the current study, all four trials extracted
for Nivolumab vs placebo are the ATTRACTION-2 trial, a phase III trial. Subgroup analyses
and long-term follow-ups are included, but all the same trials are extracted. In addition, five
studies were selected for Nivolumab+chemotherapy vs. chemotherapy: three studies from the
phase III CheckMate 649 trial and two studies from the phase II and III ATTRACTION-4 trials.
In other words, the extracted trials are the results of long-term follow-ups and subgroup analyses
of almost the same clinical trials. Therefore, if it is Nivolumab alone, only the results of the
ATTRACTION-2 trial are being looked at. Furthermore, if it is Nivolumab plus chemotherapy,
there are only two trials, the CheckMate649 trial and the ATTRACTION-4 trial. With these
results, I think it is hard to call it a meta-analysis analysis. At least concerning nivolumab
monotherapy, it is the same clinical trial.
assistant