Chinese PLA Medical School, Beijing 100853, China.
Medical Oncology Department, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Nutrients. 2023 Oct 8;15(19):4290. doi: 10.3390/nu15194290.
In recent years, the therapeutic effect of monoclonal antibodies against programmed cell death protein-1 (PD-1) in patients with locally advanced or metastatic gastric or gastroesophageal junction (G/GEJ) cancer has been confirmed in many studies. The exploration and discovery of new biomarker combinations based on tumor characteristics and tumor microenvironment help screen superior patients and realize precise immunotherapy. As an evaluation index of immunonutritional status, the prognostic nutritional index (PNI) is low cost, simple and easy to obtain, and effective in determining the prognosis of tumor patients. We selected 268 consecutive AGC patients who were treated with ICI therapy from December 2014 to May 2021. We measured their pretreatment of the PNI levels and performed univariate and multivariate Cox regression analyses of progression-free survival (PFS) or overall survival (OS) after ICI therapy. The low pretreatment PNI level of AGC patients was significantly correlated with shorter PFS ( < 0.001) and OS ( < 0.001) after ICI treatment. In univariate and multivariate analyses of the associations between PNI and OS or PFS, PNI is an independent prognostic factor for PFS (HR = 1.511; 95%CI 1.154-1.977; = 0.003) and OS (HR = 1.431; 95%CI 1.049-1.951; = 0.024), respectively. Notably, decreased PNI during treatment with ICIs was associated with early relapse and death. Pretreatment with PNI might help to identify AGC patients who will obtain a survival benefit from ICI therapy.
近年来，多项研究证实了抗程序性细胞死亡蛋白-1（PD-1）单克隆抗体在局部晚期或转移性胃或胃食管结合部（G/GEJ）癌患者中的治疗效果。基于肿瘤特征和肿瘤微环境，探索和发现新的生物标志物组合有助于筛选优势患者，实现精准免疫治疗。作为免疫营养状况的评价指标，预后营养指数（PNI）成本低、简单易获取，能有效判断肿瘤患者的预后。我们选择了 2014 年 12 月至 2021 年 5 月期间接受 ICI 治疗的 268 例连续 AGC 患者，测量了他们的 PNI 水平，并对 ICI 治疗后的无进展生存期（PFS）或总生存期（OS）进行了单因素和多因素 Cox 回归分析。AGC 患者的 PNI 水平较低与 ICI 治疗后较短的 PFS（<0.001）和 OS（<0.001）显著相关。在 PNI 与 OS 或 PFS 的单因素和多因素分析中，PNI 是 PFS（HR=1.511；95%CI 1.154-1.977；P=0.003）和 OS（HR=1.431；95%CI 1.049-1.951；P=0.024）的独立预后因素。值得注意的是，ICI 治疗期间 PNI 的降低与早期复发和死亡相关。治疗前 PNI 可能有助于识别从 ICI 治疗中获益的 AGC 患者。
