Tanaka Toshimitsu, Suzuki Hiroyuki, Yamaguchi Shotaro, Shimotsuura Yasutaka, Nagasu Sachiko, Murotani Kenta, Fujita Fumihiko, Kawaguchi Takumi, Miwa Keisuke
Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan.
Oncol Lett. 2024 Jul 29;28(4):463. doi: 10.3892/ol.2024.14596. eCollection 2024 Oct.
Although an association exists between the timing of immune checkpoint inhibitor (ICI) administration and therapeutic efficacy in several types of cancer, to the best of our knowledge, no reports exist regarding this relationship in gastric cancer (GC). The present study aimed to evaluate the optimal timing of ICI (nivolumab) administration in patients with advanced GC. A total of 58 consecutive patients with advanced GC who received nivolumab monotherapy after ≥2 chemotherapy regimens were retrospectively evaluated. These patients were divided into two groups according to the median time of nivolumab administration: i) Early-timing and (ii) late-timing groups, and the efficacy was assessed in both groups. The early-timing group had significantly longer overall survival (OS) than the late-timing group [median OS 8.2 months; 95% confidence interval (CI), 4.2-12.9 vs. median OS 5.4 months; 95% CI, 3.6-6.1]. Moreover, patients in the early-timing group had significantly longer progression-free survival (PFS) than those in the late-timing group (median PFS 2.6 months; 95% CI, 1.3-3.9 months vs. median PFS 1.6 months; 95% CI, 0.9-2.1 months). Furthermore, univariate analysis showed that early timing, immune-related adverse events and nonsteroidal anti-inflammatory drug administration were associated with longer OS and PFS. Cutoff Finder analysis revealed that the optimal timing of nivolumab administration for achieving better outcomes was before 12:06 p.m. Nivolumab administration in the morning, especially before 12:06 p.m., had a better clinical impact on patients with advanced GC.
尽管免疫检查点抑制剂（ICI）给药时机与几种癌症的治疗效果之间存在关联，但据我们所知，尚无关于胃癌（GC）中这种关系的报道。本研究旨在评估晚期GC患者ICI（纳武利尤单抗）给药的最佳时机。对≥2种化疗方案后接受纳武利尤单抗单药治疗的58例连续晚期GC患者进行回顾性评估。根据纳武利尤单抗给药的中位时间将这些患者分为两组：i）早给药组和（ii）晚给药组，并对两组的疗效进行评估。早给药组的总生存期（OS）明显长于晚给药组[中位OS 8.2个月；95%置信区间（CI），4.2 - 12.9个月 vs. 中位OS 5.4个月；95%CI，3.6 - 6.1个月]。此外，早给药组患者的无进展生存期（PFS）明显长于晚给药组（中位PFS 2.6个月；95%CI，1.3 - 3.9个月 vs. 中位PFS 1.6个月；95%CI，0.9 - 2.1个月）。此外，单因素分析显示，早给药、免疫相关不良事件和非甾体抗炎药的使用与更长的OS和PFS相关。Cutoff Finder分析显示，为获得更好结果，纳武利尤单抗给药的最佳时机是下午12:06之前。上午给药，尤其是下午12:06之前给药，对晚期GC患者具有更好的临床影响。
