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). (29th November 2021)

• Record Type: Journal Article
• Authors: 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, Katsuyoshi; Ueno, Nobuhiro; Kashima, Shin; Moriichi, Kentaro; Sato, Keisuke; Yuzawa, Sayaka; Tanino, Mishie; Taruiishi, Masaki; Sumi, Yasuo; Mizukami, Yusuke; Fujiya, Mikihiro; Okumura, Toshikatsu
• Is Part Of: Cancer medicine. Volume 11:Number 2(2022)
• Page Start: 406
• Page End: 416
• Publication Date: 2021-11-29
• Subjects: biomarker -- chemotherapy -- gastric carcinoma -- microsatellite instability -- nomogram; 616.994005
• DOI: 10.1002/cam4.4461
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Background: Chemotherapy for advanced gastric cancer is recommended in the guidelines; however, later‐line treatment remains controversial. Since immune checkpoint inhibitors have been used for the treatment of various malignancies, trials have been performed for gastric cancer. A phase 3 trial indicated the survival benefit of nivolumab monotherapy for gastric cancer patients treated with prior chemotherapy regimens. Patients and methods: A regional cohort study was undertaken to determine the real‐world data of nivolumab treatment for patients with advanced or recurrent gastric cancer. The patients were enrolled for 2 years from October 2017 to October 2019 and were prospectively followed for 1 year to examine the overall survival (OS). The patient characteristics were analyzed in a multivariate analysis and a nomogram to predict the probability of survival was generated. Results: In total, 70 patients who received nivolumab as ≥third‐line chemotherapy were included in the Asahikawa Gastric Cancer Cohort. The median OS was 7.5 (95% CI, 4.8–10.2) months and the response rate was 18.6%. Diffuse type classification, bone metastasis, high neutrophil/lymphocyte ratio, and high CRP were associated with poor OS/prognosis in the multivariate analysis. A nomogram was developed based on these clinical parameters and the concordance index was 0.80 (95% CI, 0.68–0.91). The responders were aged and were frequently diagnosed with intestinal type gastric cancer, including patients with a HER2‐positive status (27.3%) or microsatellite instability‐high (27.3%) status. Conclusions: The regional cohort study of nivolumab monotherapy for gastric cancer patients revealed prognostic factors and a nomogram was developed that could predict the probability of survival. Abstract : Development and validation of the nomogram. The nomogram of different risk factors for survival at 7.5 months in gastric cancer patients treated with nivolumab.