Morelli Cristina, Formica Vincenzo, Patrikidou Anna, Rofei Michela, Shiu Kai Keen, Riondino Silvia, Argirò Renato, Floris Roberto, Ferlosio Amedeo, Orlandi Augusto, Roselli Mario, Arkenau Hendrik-Tobias
Medical Oncology Unit and PhD program in Systems and Experimental Medicine (XXXV cycle), Tor Vergata University Hospital, Rome, Italy.
Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France.
J Gastrointest Oncol. 2022 Oct;13(5):2072-2081. doi: 10.21037/jgo-22-217.
Nutritional status is strongly associated to prognosis in metastatic gastrooesophageal junction (mGOJ)/gastric cancer (GC) patients. The aim of the present study was to develop an immune-checkpoint inhibitor (ICI)-specific nutritional index (NI).
Ten serum and anthropometric nutritional markers derived from blood tests or CT scans were analyzed at baseline in patients treated with second-line ICI and correlated with overall survival (OS). An ICI-specific NI (the NUTRIICI) was developed with its specificity assessed in an independent group of patients treated with standard second-line chemotherapy.
From June 2014 to December 2018, 57 mGOJ/GC patients (14 females, 43 males) with a median(m) age of 61 years (range 29-85) received ICI as second-line therapy (Pembrolizumab n=26, Nivolumab n=16, Avelumab n=15). Among the 10 analyzed variables, Onodera's prognostic NI (PNI) ≤33 and waist-to-hip (WHR) <1 were independent predictors of OS and used to build the NUTRIICI. Patients with both favorable factors (i.e., PNI >33 and WHR ≥1, comparator group) had a mOS of 18.0 6.7 months of patients with one unfavorable factor (either PNI ≤33 or WHR <1, Hazard Ratio, HR 3.06), 1.3 months of patients with both unfavorable factors (HR 17.56), overall P<0.0001. In the independent group of patients treated with standard chemotherapy NUTRIICI was not associated with prognosis (P=0.57).
NUTRIICI is the first ICI-specific NI for mOGJ/GC patients receiving second-line ICI. A validation in larger cohorts is strongly encouraged.
营养状况与转移性胃食管交界部（mGOJ）/胃癌（GC）患者的预后密切相关。本研究的目的是开发一种免疫检查点抑制剂（ICI）特异性营养指数（NI）。
在接受二线ICI治疗的患者基线时，分析了来自血液检查或CT扫描的10种血清和人体测量营养标志物，并将其与总生存期（OS）相关联。开发了一种ICI特异性NI（NUTRIICI），并在接受标准二线化疗的独立患者组中评估了其特异性。
2014年6月至2018年12月，57例mGOJ/GC患者（14例女性，43例男性），中位年龄61岁（范围29-85岁）接受ICI作为二线治疗（帕博利珠单抗n=26，纳武利尤单抗n=16，阿维鲁单抗n=15）。在分析的10个变量中，小野寺预后营养指数（PNI）≤33和腰臀比（WHR）<1是OS的独立预测因素，并用于构建NUTRIICI。两个有利因素（即PNI>33且WHR≥1，比较组）的患者中位OS为18.0个月；一个不利因素（PNI≤33或WHR<1，风险比，HR 3.06）的患者为6.7个月；两个不利因素的患者为1.3个月（HR 17.56），总体P<0.0001。在接受标准化疗的独立患者组中，NUTRIICI与预后无关（P=0.57）。
NUTRIICI是首个用于接受二线ICI治疗的mOGJ/GC患者的ICI特异性NI。强烈鼓励在更大队列中进行验证。
