PD-L1 CPS ≥1 Defines Immunotherapy Benefit in HER2-Negative Gastric Cancer
This pooled individual patient-data analysis clarifies where PD-1 antibody plus chemotherapy delivers survival benefit across programmed cell death ligand 1 (PD-L1) expression strata, informing first-line regimen selection in HER2-negative gastric and gastro-oesophageal junction adenocarcinoma.
📅 Journal publication: Jul 20, 2026·Last updated: Oct 7, 2026
Combination therapy outperforms in HER2-negative cancers with PD-L1 CPS ≥ 1.
Understanding the efficacy of PD-1 antibody plus chemotherapy based on programmed cell death ligand 1 (PD-L1) levels can guide personalized treatment for gastric and gastroesophageal junction adenocarcinoma. In patients with 1 ≤ combined positive score (CPS) < 10, the addition of PD-1 antibody to chemotherapy significantly improved overall survival (HR, 0.84; 95% CI, 0.75 to 0.93). The study supports using PD-1 antibody plus chemotherapy in patients with advanced human epidermal growth factor receptor 2 (HER2)-negative adenocarcinoma and PD-L1 CPS ≥ 1, showing limited benefit in CPS < 1. PD-1 antibody with chemotherapy improves outcomes in HER2-negative adenocarcinoma with PD-L1 CPS ≥ 1.
📊 Deep Analysis Available
Subscribers get the full breakdown: study design, outcomes, pharmacist implications, clinical pearls, GRADE evidence grade, and a downloadable PDF report.
Authors:Lai MY, Wu HX, He MM, Guan WL, Xu S, Hu H, Xu YL, Wang FH, Xu RH, Qiu MZ
Citation:Lai MY, Wu HX, He MM, et al. Clinical benefit of PD-1 antibody plus chemotherapy in advanced HER2 negative gastric or gastro-oesophageal junction adenocarcinoma according to PD-L1 levels: Post-hoc analysis of RATIONALE-305 and pooled analysis of individual patient-level data. Journal of hematology & oncology. 2026;19(1). doi:10.1186/s13045-026-01830-6
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
Want the full analysis?
Subscribe to PharmD Signal for unrestricted access to every deep analysis, plus PDF reports, GRADE evidence grades, and pharmacist implications for every article we publish.