Junmin Song, Ahmed Ashraf Morgan, Jaeun Ahn, Wing Fai Li, Yu Chang, Yu-Cheng Chang, Muhammad Fahimuddin, Kuan-Yu Chi, Lawrence W Wu, Cho-Han Chiang
{"title":"免疫检查点抑制剂和化疗对胃癌患者Khorana风险评分的影响","authors":"Junmin Song, Ahmed Ashraf Morgan, Jaeun Ahn, Wing Fai Li, Yu Chang, Yu-Cheng Chang, Muhammad Fahimuddin, Kuan-Yu Chi, Lawrence W Wu, Cho-Han Chiang","doi":"10.1080/1750743X.2025.2501922","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Patients with gastric cancer are at a high risk of venous thromboembolism (VTE), and immune checkpoint inhibitors (ICIs) may further increase this risk. While the Khorana Risk Score (KRS) has been validated primarily in chemotherapy-treated populations, its utility in ICI-treated patients remains unclear.</p><p><strong>Methods: </strong>Using the TriNetX Global Collaborative Network, we analyzed data from 2782 patients with gastric cancer treated with ICIs. Patients were stratified into high-risk (KRS ≥3) and intermediate-risk (KRS = 2) groups based on pre-treatment laboratory values and BMI. Cox proportional-hazards analyses were performed to evaluate the association between KRS and outcomes, including VTE, all-cause mortality, and arterial thrombosis, over a one-year follow-up period.</p><p><strong>Results: </strong>High-risk patients had a 26% higher risk of VTE (HR: 1.26, [95% CI: 1.06-1.50]) and a 43% higher risk of all-cause mortality (HR: 1.43, [95% CI: 1.27-1.62]) compared to intermediate-risk patients. The incidence of deep vein thrombosis (DVT) was also significantly higher in the high-risk group (HR: 1.27, [95% CI: 1.01-1.59]), but no significant differences were observed for pulmonary embolism (PE) or arterial thrombosis.</p><p><strong>Conclusion: </strong>These findings suggest the KRS may effectively stratify VTE risk and mortality in gastric cancer patients treated with ICIs.</p>","PeriodicalId":13328,"journal":{"name":"Immunotherapy","volume":" ","pages":"419-424"},"PeriodicalIF":2.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091900/pdf/","citationCount":"0","resultStr":"{\"title\":\"Validating Khorana Risk Score in gastric cancer patients on immune checkpoint inhibitors and chemotherapy.\",\"authors\":\"Junmin Song, Ahmed Ashraf Morgan, Jaeun Ahn, Wing Fai Li, Yu Chang, Yu-Cheng Chang, Muhammad Fahimuddin, Kuan-Yu Chi, Lawrence W Wu, Cho-Han Chiang\",\"doi\":\"10.1080/1750743X.2025.2501922\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Patients with gastric cancer are at a high risk of venous thromboembolism (VTE), and immune checkpoint inhibitors (ICIs) may further increase this risk. While the Khorana Risk Score (KRS) has been validated primarily in chemotherapy-treated populations, its utility in ICI-treated patients remains unclear.</p><p><strong>Methods: </strong>Using the TriNetX Global Collaborative Network, we analyzed data from 2782 patients with gastric cancer treated with ICIs. Patients were stratified into high-risk (KRS ≥3) and intermediate-risk (KRS = 2) groups based on pre-treatment laboratory values and BMI. Cox proportional-hazards analyses were performed to evaluate the association between KRS and outcomes, including VTE, all-cause mortality, and arterial thrombosis, over a one-year follow-up period.</p><p><strong>Results: </strong>High-risk patients had a 26% higher risk of VTE (HR: 1.26, [95% CI: 1.06-1.50]) and a 43% higher risk of all-cause mortality (HR: 1.43, [95% CI: 1.27-1.62]) compared to intermediate-risk patients. The incidence of deep vein thrombosis (DVT) was also significantly higher in the high-risk group (HR: 1.27, [95% CI: 1.01-1.59]), but no significant differences were observed for pulmonary embolism (PE) or arterial thrombosis.</p><p><strong>Conclusion: </strong>These findings suggest the KRS may effectively stratify VTE risk and mortality in gastric cancer patients treated with ICIs.</p>\",\"PeriodicalId\":13328,\"journal\":{\"name\":\"Immunotherapy\",\"volume\":\" \",\"pages\":\"419-424\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091900/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Immunotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/1750743X.2025.2501922\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Immunotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/1750743X.2025.2501922","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Validating Khorana Risk Score in gastric cancer patients on immune checkpoint inhibitors and chemotherapy.
Introduction: Patients with gastric cancer are at a high risk of venous thromboembolism (VTE), and immune checkpoint inhibitors (ICIs) may further increase this risk. While the Khorana Risk Score (KRS) has been validated primarily in chemotherapy-treated populations, its utility in ICI-treated patients remains unclear.
Methods: Using the TriNetX Global Collaborative Network, we analyzed data from 2782 patients with gastric cancer treated with ICIs. Patients were stratified into high-risk (KRS ≥3) and intermediate-risk (KRS = 2) groups based on pre-treatment laboratory values and BMI. Cox proportional-hazards analyses were performed to evaluate the association between KRS and outcomes, including VTE, all-cause mortality, and arterial thrombosis, over a one-year follow-up period.
Results: High-risk patients had a 26% higher risk of VTE (HR: 1.26, [95% CI: 1.06-1.50]) and a 43% higher risk of all-cause mortality (HR: 1.43, [95% CI: 1.27-1.62]) compared to intermediate-risk patients. The incidence of deep vein thrombosis (DVT) was also significantly higher in the high-risk group (HR: 1.27, [95% CI: 1.01-1.59]), but no significant differences were observed for pulmonary embolism (PE) or arterial thrombosis.
Conclusion: These findings suggest the KRS may effectively stratify VTE risk and mortality in gastric cancer patients treated with ICIs.
期刊介绍：
Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field.
Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.
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