Department of General Surgical Science, Graduate School of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Department of Gastroenterology, Gunma Prefectural Cancer Center, Ota, Gunma, Japan.
Ann Surg Oncol. 2022 Nov;29(12):7400-7406. doi: 10.1245/s10434-022-12226-4. Epub 2022 Jul 20.
Identification of positive biomarkers for the effects of nivolumab on patients with advanced gastric cancer (AGC) is significant. The Gustave Roussy Immune Score (GRIm-s) is associated with therapeutic resistance of immune checkpoint inhibitors (ICIs) in other cancers. This multicenter, retrospective study was designed to analyze the association of GRIm-s with therapeutic sensitivity of nivolumab in patients with AGC.
We reviewed 58 patients with AGC treated with nivolumab from October 2017 to November 2018 at five participating institutions. We performed blood tests before the start of nivolumab and after administration of two courses. We evaluated the correlation between the best overall response and GRIm-s. Additionally, we focused on the changes in GRIm-s before the start of nivolumab and after administration of two courses.
Of the 58 patients, 21 (36.2%) were classified into the disease control (DC) group and 37 (63.8%) into the progressive disease (PD) group. GRIm-s before nivolumab treatment did not correlate with the best therapeutic response (p = 0.086). However, GRIm-s after two courses of nivolumab showed that significantly more PD cases were in the high-risk group (p < 0.0001). After two courses of nivolumab, overall survival was significantly worse in the high-risk group (p < 0.0001). For progression-free survival, the high-risk group had a significantly worse prognosis both before (p = 0.04) and after two courses of nivolumab treatment (p < 0.0001).
GRIm-s after two courses of nivolumab and its changes compared to pretreatment values proved beneficial in predicting nivolumab sensitivity.
鉴定纳武利尤单抗治疗晚期胃癌（AGC）患者效果的阳性生物标志物具有重要意义。古斯塔夫·鲁西免疫评分（GRIm-s）与其他癌症中免疫检查点抑制剂（ICI）的治疗耐药性相关。本多中心、回顾性研究旨在分析 GRIm-s 与纳武利尤单抗治疗 AGC 患者的敏感性之间的关系。
我们回顾了 2017 年 10 月至 2018 年 11 月在五家参与机构接受纳武利尤单抗治疗的 58 例 AGC 患者。我们在开始纳武利尤单抗治疗前和两个疗程后进行了血液检测。我们评估了最佳总缓解率与 GRIm-s 的相关性。此外，我们还关注了开始纳武利尤单抗治疗前和两个疗程后 GRIm-s 的变化。
在 58 例患者中，21 例（36.2%）被归入疾病控制（DC）组，37 例（63.8%）归入进展性疾病（PD）组。纳武利尤单抗治疗前的 GRIm-s 与最佳治疗反应无关（p = 0.086）。然而，两个疗程后的 GRIm-s 显示，更多的 PD 病例处于高风险组（p < 0.0001）。纳武利尤单抗治疗两个疗程后，高风险组的总生存期明显更差（p < 0.0001）。对于无进展生存期，高风险组在纳武利尤单抗治疗前（p = 0.04）和两个疗程后（p < 0.0001）的预后均明显更差。
纳武利尤单抗两个疗程后的 GRIm-s 及其与治疗前值的变化有助于预测纳武利尤单抗的敏感性。
