错配修复缺陷晚期胃癌患者一线使用尼妥珠单抗加化疗疗效的相关因素。

IF 6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastric Cancer Pub Date : 2024-07-01 Epub Date: 2024-05-23 DOI:10.1007/s10120-024-01509-2
Young-Gyu Park, Hyung-Don Kim, Jaewon Hyung, Young Soo Park, Min-Hee Ryu
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引用次数: 0

摘要

背景:我们旨在研究导致缺乏错配修复蛋白(d-MMR)胃癌(GC)患者接受nivolumab联合化疗(nivolumab化疗)的不同临床结局的临床病理因素:这项回顾性研究纳入了28例接受尼妥珠单抗一线化疗的d-MMR晚期胃癌患者。作为对照组,纳入了68名仅接受一线化疗的患者。研究分析了中性粒细胞与淋巴细胞比值(NLR)和PD-L1联合阳性评分(CPS)等临床病理因素对疗效的影响:结果:无进展生存期(PFS)更长(中位PFS;未达到[NR]对5.2个月,危险比[HR]0.28,P 结论:Nivolumab化疗与无进展生存期(PFS)相关:在d-MMR GC患者中,尼妥珠单抗化疗的疗效优于单纯化疗,但对于NLR较高的患者,即使使用尼妥珠单抗化疗,生存率也较低。在接受 nivolumab 化疗的 d-MMR 患者中,根据 PD-L1 CPS 的不同,生存结果也没有差异。
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Factors associated with the efficacy of first-line nivolumab plus chemotherapy in advanced gastric cancer patients with deficient mismatch repair.

Background: We aimed to investigate clinicopathologic factors leading to different clinical outcomes in patients with deficient mismatch repair protein (d-MMR) gastric cancer (GC) treated with nivolumab plus chemotherapy (nivolumab chemotherapy).

Methods: This retrospective study included 28 patients with d-MMR advanced GC treated with first-line nivolumab chemotherapy. As a control group, 68 treated with first-line chemotherapy alone were included. Clinicopathological factors, including the neutrophil-to-lymphocyte ratio (NLR) and PD-L1 combined positive score (CPS), were analyzed with regards to the efficacy outcomes.

Results: Progression-free survival (PFS) was longer (median PFS; not reached [NR] vs. 5.2 months, hazard ratio [HR] 0.28, P < 0.001), and overall survival (OS) tended to be longer (median OS; NR vs. 17.9 months, HR 0.43, P = 0.057) in patients treated with nivolumab chemotherapy than those treated with chemotherapy. The PFS benefit of nivolumab chemotherapy over chemotherapy was pronounced in the subgroup with a lower NLR (< 3.80 [median NLR]) (HR 0.10), whereas it was less prominent in patients with a high NLR (≥ 3.80) (HR 0.58). Among patients treated with nivolumab chemotherapy, PFS was worse in patients with a higher NLR (≥ 3.80) than in those with a lower NLR (< 3.80), and survival outcomes were similar between those with PD-L1 CPS ≥ 5 and < 5.

Conclusion: Nivolumab chemotherapy was associated with better efficacy outcomes than chemotherapy alone among patients with d-MMR GC, but survival outcomes were poor even with nivolumab chemotherapy for those with a high NLR. Survival outcomes were not different according to PD-L1 CPS among d-MMR patients treated with nivolumab chemotherapy.

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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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