Combined systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) predicts chemotherapy response and prognosis in locally advanced gastric cancer patients receiving neoadjuvant chemotherapy with PD-1 antibody sintilimab and XELOX: a prospective study

Ding, Pingan; Guo, Honghai; Sun, Chenyu; Yang, Peigang; Kim, Na Hyun; Tian, Yuan; Liu, Yang; Liu, Pengpeng; Li, Yong; Zhao, Qun

doi:10.1186/s12876-022-02199-9

Cited by 46 publications

(23 citation statements)

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“…A high inflammatory response leads to the release of a series of inflammatory mediators from tumor cells, causing oxidative damage and DNA mutation, which in turn alters the tumor microenvironment and promotes the proliferation and migration of tumor cells ( 47 , 48 ). The systemic inflammatory response will aggravate malnutrition and decline in body function of patients with malignant tumors, which will promote poor prognosis of patients with malignant tumors ( 29 , 30 ). It has been reported that muscle hormones secreted by myocytes can inhibit the growth of tumor cells, and that muscle hormone expression may be reduced in sarcopenia, leading to tumor proliferation and recurrence ( 49 ).…”

Section: Discussionmentioning

confidence: 99%

“…Peripheral venous blood was collected from all patients on an empty stomach within 1 week before surgery. Peripheral blood neutrophil, lymphocyte, and platelet counts in LAGC patients were analyzed by the method in our previous study ( 29 , 30 ). The specific operation process is as follows: using an automatic hematology analyzer (Beckman Coulter LH750) to measure and analyze the counts of neutrophils, platelets and lymphocytes, and the albumin level using an automatic hematology analyzer (Beckman Coulter AU5800) assay analysis.…”

Section: Methodsmentioning

confidence: 99%

“…The specific operation process is as follows: using an automatic hematology analyzer (Beckman Coulter LH750) to measure and analyze the counts of neutrophils, platelets and lymphocytes, and the albumin level using an automatic hematology analyzer (Beckman Coulter AU5800) assay analysis. The SII was defined as follows: SII = P × N/L, where P, N, and L were the platelet, neutrophil, and lymphocyte counts, respectively ( 29 , 30 , 33 ). Similarly, PNI is calculated by albumin plus 5 times lymphocyte count ( 34 ).…”

Section: Methodsmentioning

confidence: 99%

“…The increase of inflammatory cytokines in the body promotes the increase of muscle metabolism, which will further induce the imbalance of muscle protein synthesis and catabolism ( 27 , 28 ). The systemic inflammatory immunity index (SII) is a new inflammatory index based on peripheral blood neutrophil, lymphocyte and platelet counts that adequately reflects the balanced relationship between immunity and inflammation ( 29 , 30 ). A recent cross-sectional study that included 4,224 elderly patients found that higher SII levels were associated with an increased prevalence of sarcopenia ( 31 ).…”

Section: Introductionmentioning

confidence: 99%

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Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer

Ding

Sun

et al. 2022

Front. Nutr.

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BackgroundSarcopenia is associated with poor clinical outcomes in patients with locally advanced gastric cancer (LAGC). Currently, the diagnostic criteria for sarcopenia are complex and laborious. Increased evidence suggests the inflammatory state of the body is closely associated with the development of sarcopenia. The systemic immune-inflammatory index (SII) and the prognostic nutritional index (PNI) are representative blood indicators of the status of the systemic inflammatory response, but the clinical significance of the combined testing of these two indicators remains unclear. We aimed to develop a simple and practical risk score (SII-PNI score) to screen patients with LAGC for sarcopenia on admission for early diagnosis.MethodsWe registered a prospective clinical study from January 2011 to May 2016 involving 134 patients with LAGC undergoing radical surgical resection. All patients followed the definition of sarcopenia in the Asian Working Group on Sarcopenia (AWGS) guidelines and were divided into sarcopenia and non-sarcopenia groups. SII-PNI score 0–2 was scored as 2 for high SII (≥432.9) and low PNI ( ≤ 49.5); score 1, either high SII or low PNI; score 0, no high SII or low PNI.ResultsAll patients underwent radical surgery, including 31 patients (23.13%) with sarcopenia according to AWGS criteria. The SII-PNI score was significantly lower in the non-sarcopenic patients than in the sarcopenic patients (p < 0.001). Logistic multivariate analysis showed that the SII-PNI score predicted an independent prognostic factor for sarcopenia (p < 0.001). Patients with high SII-PNI scores had significantly worse prognosis than those with low SII-PNI scores (p < 0.001). The SII-PNI score was an independent prognostic factor for predicting overall survival and disease-free survival (p = 0.016, 0.023).ConclusionPeripheral blood parameters SII-PNI scores accurately identify sarcopenia in patients with LAGC and could be used as potential systemic markers.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer

Ding

Sun

et al. 2022

Front. Nutr.

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“…Although the tumor-node-metastasis (TNM) staging system is currently the most authoritative tool for prognosis prediction, many indicators have been reported to play a role in predicting the short-term or long-term prognosis of gastric cancer patients, such as the neutrophil to platelet ratio (NPR) ( 6 ), red cell distribution width (RDW) ( 7 ), C-reactive protein to albumin ratio (CAR) ( 8 ), albumin to fibrinogen ratio (AFR) ( 9 ), prognostic nutritional index (PNI) ( 10 ), and systemic immune-inflammatory index (SII) ( 11 ). However, these parameters are not widely applied in clinics due to the disadvantages of instability and large differences in baseline values.…”

Section: Introductionmentioning

confidence: 99%

Predictive role of preoperative geriatric nutritional risk index for clinical outcomes in surgical gastric cancer patients: A meta-analysis

Shen²,

Zou³

et al. 2022

Front. Surg.

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PurposeThe association between the preoperative Geriatric Nutritional Risk Index (GNRI) and postoperative short-term and long-term clinical outcomes remains unclear. The aim of this meta-analysis was to identify the predictive role of the preoperative GNRI for postoperative clinical outcomes of gastric cancer patients based on current evidence.MethodsSeveral databases were searched up to July 28, 2022. The primary and secondary outcomes were long-term survival, including overall survival (OS), cancer-specific survival (CSS) and postoperative complications. Meanwhile, the hazard ratios (HRs) and relative risks (RRs) with 95% confidence intervals (CIs) were combined to assess the association of preoperative GNRI with postoperative survival and complications separately. The results Eight studies involving 4,189 patients were included, and they were all from Japan. The pooled results demonstrated that a lower preoperative GNRI was significantly related to worse OS (HR = 1.72, 95% CI: 1.18–2.53, P = 0.005) and CSS (HR = 1.67, 95% CI: 1.20–2.32, P = 0.002). Meanwhile, a lower preoperative GNRI was significantly associated with postoperative complications (RR = 1.97, 95% CI: 1.51–2.58, P < 0.001). Further analysis focusing on elderly patients showed similar results.ConclusionPreoperative GNRI is related to postoperative short-term and long-term clinical outcomes of Japanese gastric cancer patients, and a lower GNRI predicts poorer prognosis.

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Chemotherapy and Immune Checkpoint Blockade for Gastric and Gastroesophageal Junction Adenocarcinoma

Manji,

Lee,

Del Portillo

et al. 2023

JAMA Oncol

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ImportanceCombining immune checkpoint blockade (ICB) with chemotherapy improves outcomes in patients with metastatic gastric and gastroesophageal junction (G/GEJ) adenocarcinoma; however, whether this combination has activity in the perioperative setting remains unknown.ObjectiveTo evaluate the safety and preliminary activity of perioperative chemotherapy and ICB followed by maintenance ICB in resectable G/GEJ adenocarcinoma.Design, Setting, and ParticipantsThis investigator-initiated, multicenter, open-label, single-stage, phase 2 nonrandomized controlled trial screened 49 patients and enrolled 36 patients with resectable G/GEJ adenocarcinoma from February 10, 2017, to June 17, 2021, with a median (range) follow-up of 35.2 (17.4-73.0) months. Thirty-four patients were deemed evaluable for efficacy analysis, with 28 (82.4%) undergoing curative resection. This study was performed at 4 referral institutions in the US.InterventionsPatients received 3 cycles of capecitabine, 625 mg/m2, orally twice daily for 21 days; oxaliplatin, 130 mg/m2, intravenously and pembrolizumab, 200 mg, intravenously with optional epirubicin, 50 mg/m2, every 3 weeks before and after surgery with an additional cycle of pembrolizumab before surgery. Patients received 14 additional doses of maintenance pembrolizumab.Main Outcomes and MeasuresThe primary end point was pathologic complete response (pCR) rate. Secondary end points included overall response rate, disease-free survival (DFS), overall survival (OS), and safety.ResultsA total of 34 patients (median [range] age, 65.5 [25-90] years; 23 [67.6%] male) were evaluable for efficacy. Of these patients, 28 (82.4%) underwent curative resection, 7 (20.6%; 95% CI, 10.1%-100%) achieved pCR, and 6 (17.6%) achieved a pathologic near-complete response. Of the 28 patients who underwent resection, 4 (14.3%) experienced disease recurrence. The median DFS and OS were not reached. The 2-year DFS was 67.8% (95% CI, 0.53%-0.87%) and the OS was 80.6% (95% CI, 0.68%-0.96%). Treatment-related grade 3 or higher adverse events for evaluable patients occurred in 20 patients (57.1%), and 12 (34.3%) experienced immune-related grade 3 or higher adverse events.Conclusion and RelevanceIn this trial of unselected patients with resectable G/GEJ adenocarcinoma, capecitabine, oxaliplatin, and pembrolizumab resulted in a pCR rate of 20.6% and was well tolerated. This trial met its primary end point and supports the development of checkpoint inhibition in combination with perioperative chemotherapy in locally advanced G/GEJ adenocarcinoma.Trial RegistrationClinicalTrials.gov Identifier: NCT02918162

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Combined systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) predicts chemotherapy response and prognosis in locally advanced gastric cancer patients receiving neoadjuvant chemotherapy with PD-1 antibody sintilimab and XELOX: a prospective study

Cited by 46 publications

References 35 publications

Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer

Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer

Predictive role of preoperative geriatric nutritional risk index for clinical outcomes in surgical gastric cancer patients: A meta-analysis

Chemotherapy and Immune Checkpoint Blockade for Gastric and Gastroesophageal Junction Adenocarcinoma

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