Mildanoglu Maral Martin, Kutlu Yasin, Bas Onur, Koylu Bahadır, Dae Shute Ailia, Sakin Abdullah, Erdem Dilek, Sendur Mehmet Ali Nahit, Tasci Elif Senocak, Dane Faysal, Kaya Ali Osman, Aykan Musa Baris, Ergun Yakup, Biter Sedat, Dizdar Omer, Disel Umut, Selcukbiricik Fatih, Kose Fatih, Olmez Omer Fatih, Demir Gokhan, Yalcin Suayib, Bilici Ahmet
Department of Medical Oncology, Faculty of Medicine, Medipol University, Istanbul, 34083, Turkey.
Department of Medical Oncology, Tokat State Hospital, Tokat, 60100, Turkey.
Sci Rep. 2025 Jul 13;15(1):25336. doi: 10.1038/s41598-025-09707-3.
Our understanding of prognostic and predictive factors in the context of nivolumab combined with chemotherapy remains limited. In our multicenter study conducted across 16 centers, data from 153 patients with metastatic gastric adenocarcinoma and a PD-L1 CPS score ≥ 5, who received nivolumab in combination with chemotherapy as first-line treatment, were retrospectively analyzed for the period between 2021 and 2024. The study aimed to investigate the prognostic and predictive significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Systemic Immune-Inflammation Index (SII), as well as various clinical parameters. The estimated median progression-free survival (PFS) was 11.06 months while the estimated median overall survival (OS) was 16.03 months. Patients who were initially diagnosed with metastatic disease had a significantly worse prognosis, as was those with lung metastases. Lower NLR, PLR, and SII values were associated with longer PFS and OS in the univariate analysis; however, their statistical significance was not mantained in the multivariate analysis. SII and PD-L1 CPS score were determined as independent predictive factors for nivolumab plus chemotherapy treatment response. Our study is the only one to date that sheds light on prognostic and predictive factors in patients with metastatic gastric or GEJ adenocarcinoma and a PD-L1 CPS score ≥ 5, who received nivolumab in combination with chemotherapy.
我们对纳武利尤单抗联合化疗背景下的预后和预测因素的理解仍然有限。在我们在16个中心开展的多中心研究中，对2021年至2024年期间153例转移性胃腺癌且PD-L1综合阳性评分（CPS）≥5、接受纳武利尤单抗联合化疗作为一线治疗的患者数据进行了回顾性分析。该研究旨在调查中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、全身免疫炎症指数（SII）以及各种临床参数的预后和预测意义。估计的中位无进展生存期（PFS）为11.06个月，而估计的中位总生存期（OS）为16.03个月。最初诊断为转移性疾病的患者预后明显更差，有肺转移的患者也是如此。在单因素分析中，较低的NLR、PLR和SII值与更长的PFS和OS相关；然而，在多因素分析中它们的统计学意义未得到维持。SII和PD-L1 CPS评分被确定为纳武利尤单抗加化疗治疗反应的独立预测因素。我们的研究是迄今为止唯一一项揭示转移性胃或胃食管交界腺癌且PD-L1 CPS评分≥5、接受纳武利尤单抗联合化疗患者的预后和预测因素的研究。
