Prognostic factors to predict the survival in patients with advanced gastric cancer who receive later‐line nivolumab monotherapy—The Asahikawa Gastric Cancer Cohort Study (AGCC)

Tanaka, Kazuyuki; Tanabe, Hiroki; Sato, Hiroki; Ishikawa, Chisato; Goto, Mitsuru; Yanagida, Naoyuki; Akabane, Hiromitsu; Yokohama, Shiro; Hasegawa, Kimiharu; Kitano, Yohei; Sugiyama, Yuya; Uehara, Kyoko; Kobayashi, Yu; Murakami, Yuki; Kunogi, Takehito; Sasaki, Takahiro; Takahashi, Keitaro; Ando, Koji; Ueno, Nobuhiro; Kashima, Shin; Moriichi, Kentaro; Sato, Keisuke; Yuzawa, Sayaka; Tanino, Mishie; Taruiishi, Masaki; Sumi, Yasuo; Mizukami, Yusuke; Fujiya, Mikihiro; Okumura, Toshikatsu

doi:10.1002/cam4.4461

Cited by 12 publications

(13 citation statements)

References 32 publications

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“…Although the differentiated histological type is an advantage of AGC ( 52 ), this case was a poorly differentiated adenocarcinoma with a good response to nivolumab. Distinct from our case, previous studies have suggested that HER-2 -positive status is related to the improvement of prognosis ( 18 , 53 ). Furthermore, some studies have proposed that the co-expression of HER-2 and PD-L1 may contribute to the immune escape of GC, meaning that HER-2 -negative status creates favorable conditions for effective immunotherapy ( 12 ).…”

Section: Discussioncontrasting

confidence: 80%

“…The significant anti-tumor effect, low response rate, and high incidence of immune-related adverse events (IRAEs) of nivolumab make its applicable conditions and optimal withdrawal time controversial ( 16 – 18 ). The ATTRACTION-2 trial has shown that the complete response rate was only 1.1% in the overall population, and 50% of the patients exhibited early disease progression.…”

Section: Introductionmentioning

confidence: 99%

“…IRAEs represent the off-target effect caused by nivolumab, which coexists with the on-target effect , i.e., the anti-tumor effect. A proportion of patients can achieve long-term survival through immunotherapy, and patients with IRAEs have a longer survival time than those without ( 18 , 21 ). Our patient had an excellent response to nivolumab.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Complete Remission of a Patient With Metastatic Gastric Cancer Treated With Nivolumab Combined With Chemotherapy After Palliative Surgery

et al. 2022

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Metastatic advanced gastric cancer, for which treatment strategies are extremely limited, has a poor prognosis. Complete remission is rare. Patients usually lose the opportunity of therapeutic surgery because the lesions cannot be completely removed, although it can greatly prolong their survival time. Palliative surgery usually suggests bad outcomes. In recent years, the immune checkpoint inhibitor (ICI) nivolumab has shown significant efficacy in the treatment of advanced gastric cancer. However, its applicable conditions and optimal withdrawal time remain controversial owing to its low response rate and high incidence of immune-related adverse events. Herein, we introduce a 66-year-old male patient with advanced gastric cancer with multiple liver metastases who underwent laparoscopic total gastrectomy for acute gastric bleeding. The patient received eight cycles of S-1 plus oxaliplatin (SOX) and switched to eight cycles of SOX plus nivolumab combined regimen in a stable state, later achieving complete remission. There was no recurrence for 32 months after the surgery. This is the first reported case of gastric cancer with multiple liver metastases with long-term complete remission with nivolumab treatment after palliative surgery. The potential mechanism of complete remission was discussed through clinical, genomic, and immune characteristics. The patient had a history of psoriasis and was positive for programmed death ligand 1 (PD-L1), and the interaction of TP53 mutation and HER-2 (-) gene may be associated with complete remission.

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Section: Discussioncontrasting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Case Report: Complete Remission of a Patient With Metastatic Gastric Cancer Treated With Nivolumab Combined With Chemotherapy After Palliative Surgery

et al. 2022

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“…For unresectable ESCC in the immunotherapy era, a traditional TNM staging system was inadequate for directing the treatment protocols. The nomogram, a visual representation of a multiple regression analysis model, has been widely used in tumor prognostic analysis [ 54 , 55 ]. As a statistical tool, it could provide a tailored risk prediction, as well as compute individual predicted survival probabilities at different time points.…”

Section: Discussionmentioning

confidence: 99%

Nomogram Based on Monocyte-to-Lymphocyte Ratio to Predict Survival of Unresectable Esophageal Squamous Cell Carcinoma Who Receive First-Line PD-1/PD-L1 Inhibitors Combined with Chemotherapy

Ding

Qian

et al. 2022

Current Oncology

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Background. Chemoimmunotherapy has become the first-line treatment for unresectable esophageal squamous cell carcinoma (ESCC). Still, reliable biomarkers to identify patients who could benefit from this combined therapy remain uncertain. This study focused on elucidating the predictive significance of the monocyte-to-lymphocyte ratio (MLR) and establishing the prognostic nomogram for unresectable ESCC treated with chemoimmunotherapy. Methods. Data of clinical features, peripheral blood parameters, and treatment records were collected in unresectable ESCC patients who received PD-1/PD-L1 inhibitors plus chemotherapy as the first-line treatment from September 2017 to August 2021. The nomogram based on MLR and clinical parameters for predicting the overall survival (OS) was developed and validated. Results. Out of 81 patients enrolled, patients with a lower MLR had significantly longer progression-free survival (PFS) and OS than patients with a higher pretreatment MLR (p = 0.0067; p = 0.00069). The OS nomogram integrating MLR, performance status (PS) score, and body mass index (BMI) achieved a C-index of 0.770 (95%CI 0.645–0.896). The area under the ROC curve (AUC) value of the nomogram predicting 12-, 18-, and 24-month OS rates were 0.855, 0.792, and 0.744, respectively, which were higher than the clinical TNM staging system or the MLR. Stratified by the nomogram-generated scores, three risk groups (low, moderate, and high) in survival curves manifested a distinct difference (p < 0.0001). Conclusion. MLR emerged as an independent predictive factor for PFS and OS in treatment-naive unresectable ESCC patients treated with chemoimmunotherapy. The constructed nomogram of MLR and clinical parameters was a reliable model for prognostic estimation.

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“…The significant anti-tumor effect, low response rate, and high incidence of immune-related adverse events (IRAEs) of nivolumab make its applicable conditions and optimal withdrawal time controversial (16)(17)(18). The ATTRACTION-2 trial has shown that the complete response rate was only 1.1% in the overall population, and 50% of the patients exhibited early disease progression.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors to predict the survival in patients with advanced gastric cancer who receive later‐line nivolumab monotherapy—The Asahikawa Gastric Cancer Cohort Study (AGCC)

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 12 publications

References 32 publications

Case Report: Complete Remission of a Patient With Metastatic Gastric Cancer Treated With Nivolumab Combined With Chemotherapy After Palliative Surgery

Case Report: Complete Remission of a Patient With Metastatic Gastric Cancer Treated With Nivolumab Combined With Chemotherapy After Palliative Surgery

Nomogram Based on Monocyte-to-Lymphocyte Ratio to Predict Survival of Unresectable Esophageal Squamous Cell Carcinoma Who Receive First-Line PD-1/PD-L1 Inhibitors Combined with Chemotherapy

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