S. Udagawa, A. Ooki, H. Osumi, K. Yoshino, M. Tamba, K. Shimozaki, S. Fukuoka, T. Wakatsuki, M. Ogura, E. Shinozaki, K. Chin, K. Yamaguchi
{"title":"The clinical utility of an mGPS and SII combined score in patients with advanced gastric cancer treated with nivolumab monotherapy","authors":"S. Udagawa, A. Ooki, H. Osumi, K. Yoshino, M. Tamba, K. Shimozaki, S. Fukuoka, T. Wakatsuki, M. Ogura, E. Shinozaki, K. Chin, K. Yamaguchi","doi":"10.1016/j.esmogo.2025.100177","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Several nutritional and inflammatory indices can predict the efficacy of immune checkpoint inhibitors and the prognosis in various cancers. However, indices that are useful for patients with advanced gastric cancer (AGC) remain unclear.</div></div><div><h3>Materials and methods</h3><div>This retrospective study was conducted at a single cancer center. Patients with AGC who received nivolumab as a third- or later-line treatment between June 2017 and May 2023 were selected. The association between nutritional and inflammatory indices and clinical outcomes was analyzed.</div></div><div><h3>Results</h3><div>In total, 277 patients were analyzed. Multivariate analysis revealed that several indices were significantly associated with time to treatment failure (TTF) and overall survival (OS) after adjustment for clinicopathological factors. The modified Glasgow prognostic score (mGPS) and systemic immune-inflammation index (SII) were identified as the most promising indices. A combined score (CS) developed by summing the SII and mGPS was associated with a shorter TTF and OS in CS 1 or 2 than in CS 0 [TTF: hazard ratio (HR) 1.39, 95% confidence interval (CI) 1.04-1.87, <em>P</em> = 0.03 for CS 1 and HR 2.04, 95% CI 1.49-2.80, <em>P</em> < 0.01 for CS 2; OS: HR 1.45, 95% CI 1.08-1.96, <em>P</em> < 0.01 for CS 1 and HR 2.81, 95% CI 2.06-3.82, <em>P</em> < 0.01 for CS 2]. CS 2 had a positive predictive value of 78.1% for detecting the first progressive disease. The clinical significance of CS was also confirmed in the first-line cohort.</div></div><div><h3>Conclusion</h3><div>CS may be useful for predicting treatment efficacy and prognosis in nivolumab-treated patients with AGC.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"8 ","pages":"Article 100177"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESMO Gastrointestinal Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949819825000469","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Several nutritional and inflammatory indices can predict the efficacy of immune checkpoint inhibitors and the prognosis in various cancers. However, indices that are useful for patients with advanced gastric cancer (AGC) remain unclear.
Materials and methods
This retrospective study was conducted at a single cancer center. Patients with AGC who received nivolumab as a third- or later-line treatment between June 2017 and May 2023 were selected. The association between nutritional and inflammatory indices and clinical outcomes was analyzed.
Results
In total, 277 patients were analyzed. Multivariate analysis revealed that several indices were significantly associated with time to treatment failure (TTF) and overall survival (OS) after adjustment for clinicopathological factors. The modified Glasgow prognostic score (mGPS) and systemic immune-inflammation index (SII) were identified as the most promising indices. A combined score (CS) developed by summing the SII and mGPS was associated with a shorter TTF and OS in CS 1 or 2 than in CS 0 [TTF: hazard ratio (HR) 1.39, 95% confidence interval (CI) 1.04-1.87, P = 0.03 for CS 1 and HR 2.04, 95% CI 1.49-2.80, P < 0.01 for CS 2; OS: HR 1.45, 95% CI 1.08-1.96, P < 0.01 for CS 1 and HR 2.81, 95% CI 2.06-3.82, P < 0.01 for CS 2]. CS 2 had a positive predictive value of 78.1% for detecting the first progressive disease. The clinical significance of CS was also confirmed in the first-line cohort.
Conclusion
CS may be useful for predicting treatment efficacy and prognosis in nivolumab-treated patients with AGC.
一些营养和炎症指标可以预测免疫检查点抑制剂在各种癌症中的疗效和预后。然而，对晚期胃癌（AGC）患者有用的指标仍不清楚。材料和方法本回顾性研究在单个癌症中心进行。选择2017年6月至2023年5月期间接受纳武单抗作为三线或后期治疗的AGC患者。分析营养和炎症指标与临床结果的关系。结果共分析277例患者。多因素分析显示，调整临床病理因素后，多个指标与治疗失败时间（TTF）和总生存期（OS）显著相关。改良格拉斯哥预后评分（mGPS）和全身免疫炎症指数（SII）被认为是最有希望的指标。综合SII和mGPS得出的综合评分（CS）与CS 1或CS 2较短的TTF和OS相关[TTF：风险比（HR） 1.39, 95%可信区间（CI） 1.04-1.87, P = 0.03， CS 1和HR 2.04, 95% CI 1.49-2.80, P <；cs2为0.01；OS: HR 1.45, 95% CI 1.08-1.96, P <；cs1为0.01，HR为2.81,95% CI 2.06 ~ 3.82, P <；0.01为cs2]。cs2对首次进展性疾病的阳性预测值为78.1%。在一线队列中也证实了CS的临床意义。结论cs可用于预测尼伏单抗治疗的AGC患者的治疗效果和预后。
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