Predictive value of EBV-positivity in patients with gastric cancer treated with first-line nivolumab plus chemotherapy.

IF 5.1 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastric Cancer Pub Date : 2025-07-01 Epub Date: 2025-04-28 DOI:10.1007/s10120-025-01618-6

Hyung-Don Kim, So-Yeon Kim, Hyungeun Lee, Yuna Lee, Jaewon Hyung, Meesun Moon, Jinho Shin, Young Soo Park, Min-Hee Ryu

{"title":"Predictive value of EBV-positivity in patients with gastric cancer treated with first-line nivolumab plus chemotherapy.","authors":"Hyung-Don Kim, So-Yeon Kim, Hyungeun Lee, Yuna Lee, Jaewon Hyung, Meesun Moon, Jinho Shin, Young Soo Park, Min-Hee Ryu","doi":"10.1007/s10120-025-01618-6","DOIUrl":null,"url":null,"abstract":"Background: Epstein-Barr virus (EBV) positivity is a potential predictive biomarker for immune checkpoint inhibitors (ICIs) in gastric cancer patients, but its value in first-line ICI-based chemotherapy remains unclear. This study aimed to evaluate the predictive value of EBV positivity in patients treated with first-line nivolumab plus chemotherapy.Methods: This single-center study included advanced gastric cancer patients treated with first-line nivolumab plus chemotherapy (n = 293). Patients with EBV positivity treated with chemotherapy alone (n = 12) served as the control group. EBV positivity was confirmed by in situ hybridization.Results: Among patients treated with nivolumab plus chemotherapy, 18 (6.1%) had EBV-positive tumors, and these were associated with high PD-L1 combined positive score (CPS) expression levels. Progression-free survival (PFS) and overall survival (OS) tended to be more favorable in those with EBV-positive tumors. Multivariate analysis of patients treated with nivolumab-chemotherapy revealed that EBV positivity, combined with PD-L1 CPS ≥ 5, was an independent factor for PFS. In patients with EBV-positive tumors, nivolumab-chemotherapy was associated with significantly favorable PFS and OS compared to chemotherapy alone. Similar results were observed in the subgroup with PD-L1 CPS ≥ 5. However, survival outcomes did not differ between patients treated with nivolumab plus chemotherapy versus chemotherapy alone in the subgroup with PD-L1 CPS < 5.Conclusion: EBV positivity predicts favorable survival outcomes in patients with gastric cancer treated with nivolumab plus chemotherapy. The benefit of nivolumab plus chemotherapy over chemotherapy alone for patients with EBV positivity appears to be associated with high PD-L1 expression levels.","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"631-640"},"PeriodicalIF":5.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastric Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10120-025-01618-6","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Epstein-Barr virus (EBV) positivity is a potential predictive biomarker for immune checkpoint inhibitors (ICIs) in gastric cancer patients, but its value in first-line ICI-based chemotherapy remains unclear. This study aimed to evaluate the predictive value of EBV positivity in patients treated with first-line nivolumab plus chemotherapy.

Methods: This single-center study included advanced gastric cancer patients treated with first-line nivolumab plus chemotherapy (n = 293). Patients with EBV positivity treated with chemotherapy alone (n = 12) served as the control group. EBV positivity was confirmed by in situ hybridization.

Results: Among patients treated with nivolumab plus chemotherapy, 18 (6.1%) had EBV-positive tumors, and these were associated with high PD-L1 combined positive score (CPS) expression levels. Progression-free survival (PFS) and overall survival (OS) tended to be more favorable in those with EBV-positive tumors. Multivariate analysis of patients treated with nivolumab-chemotherapy revealed that EBV positivity, combined with PD-L1 CPS ≥ 5, was an independent factor for PFS. In patients with EBV-positive tumors, nivolumab-chemotherapy was associated with significantly favorable PFS and OS compared to chemotherapy alone. Similar results were observed in the subgroup with PD-L1 CPS ≥ 5. However, survival outcomes did not differ between patients treated with nivolumab plus chemotherapy versus chemotherapy alone in the subgroup with PD-L1 CPS < 5.

Conclusion: EBV positivity predicts favorable survival outcomes in patients with gastric cancer treated with nivolumab plus chemotherapy. The benefit of nivolumab plus chemotherapy over chemotherapy alone for patients with EBV positivity appears to be associated with high PD-L1 expression levels.

查看原文本刊更多论文

一线纳武单抗加化疗对胃癌患者ebv阳性的预测价值。

背景：eb病毒（EBV）阳性是胃癌患者免疫检查点抑制剂（ICIs）的潜在预测性生物标志物，但其在一线基于ici的化疗中的价值尚不清楚。本研究旨在评估EBV阳性在一线纳武单抗加化疗患者中的预测价值。方法：这项单中心研究纳入了接受一线纳武单抗联合化疗的晚期胃癌患者（n = 293）。单纯化疗的EBV阳性患者12例为对照组。原位杂交证实EBV阳性。结果：在接受纳武单抗联合化疗的患者中，18例（6.1%）ebv阳性肿瘤，这些患者与PD-L1联合阳性评分（CPS）表达水平高相关。ebv阳性肿瘤患者的无进展生存期（PFS）和总生存期（OS）更有利。对纳沃单抗化疗患者的多因素分析显示，EBV阳性，结合PD-L1 CPS≥5，是PFS的独立因素。在ebv阳性肿瘤患者中，与单独化疗相比，纳武单抗化疗与显著有利的PFS和OS相关。在PD-L1 CPS≥5的亚组中也观察到类似的结果。然而，在PD-L1 CPS亚组中，接受纳武单抗联合化疗与单独化疗的患者的生存结果没有差异。结论：EBV阳性预测纳武单抗联合化疗的胃癌患者的良好生存结果。对于EBV阳性患者，纳武单抗加化疗优于单独化疗的益处似乎与高PD-L1表达水平有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Gastric Cancer 医学-胃肠肝病学

CiteScore

14.70

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.