Nutritional index for immune-checkpoint inhibitor in patients with metastatic gastro-esophageal junction/gastric cancer

Abstract

Background: Nutritional status is strongly associated to prognosis in mGOJ/GC patients. The aim of the present study was to develop an ICI-specific nutritional index (NI).Methods: Ten serum and anthropometric nutritional markers derived from blood tests or CT scans were analyzed at baseline in patients treated with second-line ICI and correlated with overall survival (OS). An ICI-specific NI (the NUTRIICI) was developed with its specificity assessed in an independent group of patients treated with standard second-line chemotherapy.Results: From June 2014 to December 2018, 57 mGOJ/GC patients (14 females, 43 males) with a median(m) age of 61 years (range 29-85) received ICI as second-line therapy (Pembrolizumab n=26, Nivolumab n=16, Avelumab n=15). Among the 10 analyzed variables, Onodera's prognostic NI (PNI) ≤33 and waist-to-hip (WHR) <1 were independent predictors of OS and used to build the NUTRIICI. Patients with both favorable factors (i.e., PNI >33 and WHR ≥1, comparator group) had a mOS of 18.0 vs. 6.7 months of patients with one unfavorable factor (either PNI ≤33 or WHR <1, Hazard Ratio, HR 3.06), vs. 1.3 months of patients with both unfavorable factors (HR 17.56), overall P<0.0001. In the independent group of patients treated with standard chemotherapy NUTRIICI was not associated with prognosis (P=0.57).Conclusions: NUTRIICI is the first ICI-specific NI for mOGJ/GC patients receiving second-line ICI. A validation in larger cohorts is strongly encouraged.

Prognostic nutritional index as a prognostic biomarker for gastrointestinal cancer patients treated with immune checkpoint inhibitors

“…p < 0.05 was considered statistically significant. the eligibility criteria, resulting in a total of 2883 patients (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). The PRISMA flowchart in Figure 1 depicts the study selection process.…”

Prognostic relevance of prognostic nutritional indices in gastric or gastro-esophageal junction cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

“…A sensitivity analysis was conducted to assess the influence of individual studies on overall survival (OS) and progression-free survival (PFS).To explore the origins of heterogeneity, subgroup analyses were conducted, considering treatment modalities, sample sizes, cutoff values, and analytical models. abbreviations, and finally, 8 articles were included after full-text review (36)(37)(38)(39)(40)(41)(42)(43), These were retrospective studies with a total of 813 patients receiving ICIs. articles, These were retrospective studies, and a total of 813 patients with (GC/GEJC) treated with ICIs were included, and the flow chart is shown in Figure 1.…”

Untailored vs. Gender- and Body-Mass-Index-Tailored Skeletal Muscle Mass Index (SMI) to Assess Sarcopenia in Advanced Head and Neck Squamous Cell Carcinoma (HNSCC)

“…Sarcopenia, found in approximately 20-30% of cancer patients at diagnosis, can emerge as a chronic illness [6,7], i.e., lasting >1 year (https://www.cdc.gov/chronicdisease/about/ index.htm, accessed on 15 July 2023), and can be associated with worse surgical outcome and survival, as well as higher treatment-related toxicity [8]. More recently, its prognostic role has been confirmed also in patients treated with immune check-point inhibitors across multiple tumor types [9][10][11]. Computed tomography (CT)-derived skeletal muscle mass index (SMI) was proposed to quantify the total amount of skeletal muscle mass and assess sarcopenia [12].…”