{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T14:07:15Z","timestamp":1772287635399,"version":"3.50.1"},"reference-count":20,"publisher":"IMR Press","issue":"2","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background: The optimal regimens of third-line treatments for advanced gastric cancer have yet to be identified. This study aimed to evaluate the therapeutic efficacy of different third-line treatment regimens and to identify prognostic factors affecting patient outcomes following third-line therapy. Additionally, it sought to evaluate treatment-related adverse events and economic costs associated with different regimens, thereby providing a theoretical basis to guide the selection of third-line treatment regimens. Methods: In this real-world retrospective study, data were collected from patients diagnosed with advanced gastric cancer who fulfilled predetermined inclusion criteria. Survival outcomes between different groups were compared using Kaplan\u2013Meier survival curves and the log-rank test. Cox proportional hazards regression analysis was employed to identify prognostic factors of patients with advanced gastric cancer after receiving third-line treatment. Results: A total of 145 patients were included and divided into three groups: 45 patients in the chemotherapy-alone group, 58 patients in the immunotherapy\/targeted therapy group, and 42 patients in the chemotherapy + immunotherapy\/targeted therapy group. Survival analysis revealed a median survival time (MST) of 7.7 months (95% confidence interval [CI]: 6.8\u20138.5) for the overall cohort, while the chemotherapy + immunotherapy\/targeted therapy group demonstrated the longest MST (MST: 10.5 months; 95% CI: 8.9\u201312.1), followed by the immunotherapy\/targeted therapy group (MST: 8.5 months; 95% CI: 7.1\u20139.9). Regression analysis showed that a history of gastric surgery was an independent prognostic factor (hazard ratio [HR] = 0.639; 95% CI: 0.431\u20130.948; p = 0.026) for gastric cancer patients following third-line treatment. Regarding adverse events, the chemotherapy + immunotherapy\/targeted therapy group exhibited the highest incidence (90.5%), followed by the chemotherapy-alone group (75.6%). Cost analysis showed that the chemotherapy + immunotherapy\/targeted therapy group incurred the highest overall cost, and both total treatment costs and anti-tumor drug-related costs were positively correlated with patient survival (r2 = 0.2656 and 0.3081, respectively). Conclusion: Patients receiving third-line chemotherapy combined with immune or targeted therapy achieve the longest MST; however, this regimen is also associated with a higher incidence of adverse events and overall treatment costs.<\/jats:p>","DOI":"10.31083\/bjhm50918","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T13:29:12Z","timestamp":1772285352000},"source":"Crossref","is-referenced-by-count":0,"title":["Real-World Evaluation of the Efficacy of Third-Line Treatment Regimens for Advanced Gastric Cancer: A Single-Center Retrospective Study"],"prefix":"10.31083","volume":"87","author":[{"given":"Xiaoling","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Oncology, Zhongshan Hospital, Fudan University, 200032 Shanghai, China"},{"name":"Department of Oncology, Shanghai Clinical Research and Trial Center, ShanghaiTech University, 201210 Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Zhongshan Hospital, Fudan University, 200032 Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chouwen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Clinical Research and Trial Center, ShanghaiTech University, 201210 Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianshu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Zhongshan Hospital, Fudan University, 200032 Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Li GZ, Doherty GM, Wang J. 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World Journal of Gastroenterology. 2023; 29: 2452\u20132468.","DOI":"10.3748\/wjg.v29.i16.2452"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Oshi M, Yamada A, Gandhi S, Wu R, Sasamoto M, Yamamoto S, et al. Breast cancer in adolescents and young adults has a specific biology and poor patient outcome compared with older patients. ESMO Open. 2024; 9: 103737.","DOI":"10.1016\/j.esmoop.2024.103737"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono HA, et al. Clinicopathological features of gastric carcinoma in younger and middle-aged patients: a comparative study. Journal of Gastrointestinal Surgery : official journal of the Society for Surgery of the Alimentary Tract. 2006; 10: 1023\u20131032.","DOI":"10.1016\/j.gassur.2006.03.001"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Niu P, Huang H, Zhao L, Wang T, Zhang X, Wang W, et al. 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Gastric Cancer. 2020; 23: 143\u2013153.","DOI":"10.1007\/s10120-019-00970-8"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/2\/10.31083\/BJHM50918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T13:29:21Z","timestamp":1772285361000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/2\/10.31083\/BJHM50918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1750-8460(26)02104-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm50918","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]},"article-number":"50918"}}