Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy
Nivolumab improves overall survival (OS) in patients with advanced gastric cancer (AGC) refractory to at least two previous chemotherapy regimens. We investigated whether changes in body weight and nutrition from first-line chemotherapy to nivolumab affected its efficacy. The correlation between wei...
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/20/6100 |
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| author | Tatsuki Ikoma Toshihiko Matsumoto Yusuke Kurioka Masahiro Takatani Hiroki Nagai Yusuke Matsumoto Hironaga Satake Hisateru Yasui |
| author_facet | Tatsuki Ikoma Toshihiko Matsumoto Yusuke Kurioka Masahiro Takatani Hiroki Nagai Yusuke Matsumoto Hironaga Satake Hisateru Yasui |
| author_sort | Tatsuki Ikoma |
| collection | DOAJ |
| description | Nivolumab improves overall survival (OS) in patients with advanced gastric cancer (AGC) refractory to at least two previous chemotherapy regimens. We investigated whether changes in body weight and nutrition from first-line chemotherapy to nivolumab affected its efficacy. The correlation between weight change and nutritional status up to the start of nivolumab treatment and OS and progression-free survival (PFS) after starting nivolumab treatment was determined. Nutritional status was examined using the C-reactive protein/albumin ratio (CAR). A loss in body weight (LBW) from the onset of the first treatment of <4.5% led to OS prolongation and improved PFS outcomes. The median OS values in the LBW < 4.5% and ≥4.5% groups were 11.4 and 3.6 months, respectively. Similarly, changes in CAR from first-line chemotherapy (ΔCAR) affected OS; the ΔCAR < 0.01 group had a better prognosis than the ΔCAR ≥ 0.01 group. The median OS values in the ΔCAR < 0.01 and ≥0.01 groups were 9.4 and 4.5 months, respectively. The median OS in the group with LBW < 4.5% and ΔCAR < 0.01 was 12.9 months. LBW and deterioration of nutritional status following first-line chemotherapy are poor prognostic factors in AGC patients who received nivolumab as third- or later-line therapy. Early intervention to maintain body weight and nutritional status may improve the efficacy of immune checkpoint inhibitors. |
| first_indexed | 2024-03-09T12:14:09Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T12:14:09Z |
| publishDate | 2022-10-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-b8b3b948896045b08c229e91291454e72023-11-30T22:49:10ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011120610010.3390/jcm11206100Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab TherapyTatsuki Ikoma0Toshihiko Matsumoto1Yusuke Kurioka2Masahiro Takatani3Hiroki Nagai4Yusuke Matsumoto5Hironaga Satake6Hisateru Yasui7Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, JapanDepartment of Medical Oncology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, JapanDepartment of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji 670-8540, Hyogo, JapanDepartment of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji 670-8540, Hyogo, JapanDepartment of Medical Oncology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, JapanDepartment of Surgery, Japanese Red Cross Society Himeji Hospital, Himeji 670-8540, Hyogo, JapanDepartment of Medical Oncology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, JapanDepartment of Medical Oncology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, JapanNivolumab improves overall survival (OS) in patients with advanced gastric cancer (AGC) refractory to at least two previous chemotherapy regimens. We investigated whether changes in body weight and nutrition from first-line chemotherapy to nivolumab affected its efficacy. The correlation between weight change and nutritional status up to the start of nivolumab treatment and OS and progression-free survival (PFS) after starting nivolumab treatment was determined. Nutritional status was examined using the C-reactive protein/albumin ratio (CAR). A loss in body weight (LBW) from the onset of the first treatment of <4.5% led to OS prolongation and improved PFS outcomes. The median OS values in the LBW < 4.5% and ≥4.5% groups were 11.4 and 3.6 months, respectively. Similarly, changes in CAR from first-line chemotherapy (ΔCAR) affected OS; the ΔCAR < 0.01 group had a better prognosis than the ΔCAR ≥ 0.01 group. The median OS values in the ΔCAR < 0.01 and ≥0.01 groups were 9.4 and 4.5 months, respectively. The median OS in the group with LBW < 4.5% and ΔCAR < 0.01 was 12.9 months. LBW and deterioration of nutritional status following first-line chemotherapy are poor prognostic factors in AGC patients who received nivolumab as third- or later-line therapy. Early intervention to maintain body weight and nutritional status may improve the efficacy of immune checkpoint inhibitors.https://www.mdpi.com/2077-0383/11/20/6100nivolumabgastric cancernutritional statusbody weight losschemotherapy |
| spellingShingle | Tatsuki Ikoma Toshihiko Matsumoto Yusuke Kurioka Masahiro Takatani Hiroki Nagai Yusuke Matsumoto Hironaga Satake Hisateru Yasui Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy Journal of Clinical Medicine nivolumab gastric cancer nutritional status body weight loss chemotherapy |
| title | Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy |
| title_full | Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy |
| title_fullStr | Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy |
| title_full_unstemmed | Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy |
| title_short | Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy |
| title_sort | improvement of body weight and nutritional status in gastric cancer patients enhances the benefit of nivolumab therapy |
| topic | nivolumab gastric cancer nutritional status body weight loss chemotherapy |
| url | https://www.mdpi.com/2077-0383/11/20/6100 |
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