Prognostic nutritional index as a prognostic marker in metastatic esophageal squamous-cell carcinoma treated with immune checkpoint inhibitor

ESMO Gastrointestinal Oncology Pub Date : 2025-08-28 DOI:10.1016/j.esmogo.2025.100222

K. Yoshino, M. Tamba, H. Osumi, S. Fukuoka, M. Ogura, S. Udagawa, K. Shimozaki, T. Wakatsuki, E. Shinozaki, K. Yamaguchi, K. Chin, A. Ooki

{"title":"Prognostic nutritional index as a prognostic marker in metastatic esophageal squamous-cell carcinoma treated with immune checkpoint inhibitor","authors":"K. Yoshino, M. Tamba, H. Osumi, S. Fukuoka, M. Ogura, S. Udagawa, K. Shimozaki, T. Wakatsuki, E. Shinozaki, K. Yamaguchi, K. Chin, A. Ooki","doi":"10.1016/j.esmogo.2025.100222","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The prognostic nutritional index (PNI) is an inflammation- and nutrition-based indicator that serves as a prognostic factor for various cancer types. This study aimed to evaluate the association between PNI and survival in patients with esophageal squamous-cell carcinoma (ESCC) receiving immune checkpoint inhibitor (ICI)-based therapies.</div></div><div><h3>Materials and methods</h3><div>This single-center retrospective study included two cohorts: 109 patients treated with nivolumab monotherapy as second-line or later therapy and 92 patients receiving first-line ICI-based treatments (ICI plus chemotherapy or nivolumab plus ipilimumab).</div></div><div><h3>Results</h3><div>In the nivolumab monotherapy cohort, higher PNI (PNI ≥ 40.5) was linked to longer overall survival (OS) compared with lower PNI (16.2 versus 5.5 months, <em>P</em> = 0.001). In the first-line cohort, 92 patients received ICI plus chemotherapy (<em>n</em> = 60) or nivolumab plus ipilimumab (<em>n</em> = 32). Higher PNI was linked to better OS in both the ICI plus chemotherapy (21.2 versus 7.7 months, <em>P</em> = 0.0008) and the nivolumab plus ipilimumab (not reached versus 10.2 months, <em>P</em> = 0.02) cohorts. Multivariate analysis identified PNI status as an independent prognostic factor in both cohorts. Dynamic changes in PNI (delta PNI ≥ 1.25) 1 month after treatment were linked to better progression-free survival in patients with lower PNI receiving nivolumab monotherapy or nivolumab plus ipilimumab but not in those receiving first-line ICI plus chemotherapy.</div></div><div><h3>Conclusions</h3><div>PNI and its dynamic changes may serve as useful indicators of prognosis in patients with ESCC receiving ICI-based therapies.</div></div>","PeriodicalId":100490,"journal":{"name":"ESMO Gastrointestinal Oncology","volume":"9 ","pages":"Article 100222"},"PeriodicalIF":0.0000,"publicationDate":"2025-08-28","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/S2949819825000913","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

The prognostic nutritional index (PNI) is an inflammation- and nutrition-based indicator that serves as a prognostic factor for various cancer types. This study aimed to evaluate the association between PNI and survival in patients with esophageal squamous-cell carcinoma (ESCC) receiving immune checkpoint inhibitor (ICI)-based therapies.

Materials and methods

This single-center retrospective study included two cohorts: 109 patients treated with nivolumab monotherapy as second-line or later therapy and 92 patients receiving first-line ICI-based treatments (ICI plus chemotherapy or nivolumab plus ipilimumab).

Results

In the nivolumab monotherapy cohort, higher PNI (PNI ≥ 40.5) was linked to longer overall survival (OS) compared with lower PNI (16.2 versus 5.5 months, P = 0.001). In the first-line cohort, 92 patients received ICI plus chemotherapy (n = 60) or nivolumab plus ipilimumab (n = 32). Higher PNI was linked to better OS in both the ICI plus chemotherapy (21.2 versus 7.7 months, P = 0.0008) and the nivolumab plus ipilimumab (not reached versus 10.2 months, P = 0.02) cohorts. Multivariate analysis identified PNI status as an independent prognostic factor in both cohorts. Dynamic changes in PNI (delta PNI ≥ 1.25) 1 month after treatment were linked to better progression-free survival in patients with lower PNI receiving nivolumab monotherapy or nivolumab plus ipilimumab but not in those receiving first-line ICI plus chemotherapy.

Conclusions

PNI and its dynamic changes may serve as useful indicators of prognosis in patients with ESCC receiving ICI-based therapies.

查看原文本刊更多论文

免疫检查点抑制剂治疗转移性食管鳞状细胞癌的预后营养指标

预后营养指数（PNI）是一种基于炎症和营养的指标，可作为各种癌症类型的预后因素。本研究旨在评估PNI与接受免疫检查点抑制剂（ICI）治疗的食管鳞状细胞癌（ESCC）患者生存率之间的关系。材料和方法这项单中心回顾性研究包括两个队列：109例患者接受纳武单抗单一治疗作为二线或后期治疗，92例患者接受一线ICI治疗（ICI加化疗或纳武单抗加伊匹单抗）。在纳武单抗单药治疗队列中，与PNI较低（16.2个月对5.5个月，P = 0.001）相比，PNI较高（PNI≥40.5）与更长的总生存期（OS）相关。在一线队列中，92例患者接受了ICI +化疗（n = 60）或nivolumab + ipilimumab （n = 32）。在ICI +化疗组（21.2个月vs 7.7个月，P = 0.0008）和nivolumab + ipilimumab组（未达到vs 10.2个月，P = 0.02）中，更高的PNI与更好的OS相关。多变量分析确定PNI状态是两个队列中独立的预后因素。治疗1个月后PNI的动态变化（δ PNI≥1.25）与接受纳武单抗单药或纳武单抗联合伊匹单抗的低PNI患者更好的无进展生存有关，但与接受一线ICI加化疗的患者无关。结论spni及其动态变化可作为ESCC患者接受ici治疗后预后的有效指标。

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

ESMO Gastrointestinal Oncology

自引率

0.00%

发文量