Prognostic analysis of related factors of adverse reactions to immunotherapy in advanced gastric cancer and...

Area of Science:

• Oncology
• Immunotherapy
• Gastric Cancer Research

Background:

• Immunotherapy has gained attention for advanced gastric cancer treatment.
• Understanding adverse reactions and their prognostic impact is crucial.
• This study systematically analyzes prognostic factors in advanced gastric cancer patients undergoing immunotherapy.

Purpose of the Study:

• To identify characteristics and predictors of immune-related adverse reactions (irAEs).
• To analyze the correlation between irAEs and prognosis in advanced gastric cancer patients.
• To explore the role of programmed death protein-1 (PD-1) inhibitors in immunotherapy.

Main Methods:

• Retrospective analysis of 140 advanced gastric cancer patients treated with PD-1 inhibitors.
• Patients categorized into irAEs and non-irAEs groups.
• Multivariate logistic regression, ROC curve, Kaplan-Meier survival analysis, and Cox proportional hazard models were employed.

Main Results:

• 63 out of 132 patients (47.7%) developed irAEs.
• Differences observed in age (≥65 years), Ki-67, white blood cell count, neutrophil count, and regulatory T cell (Treg) count between groups.
• Treg count emerged as a protective factor for irAEs (P=0.030).
• Combined Treg + Ki-67 + age (≥65 years) predicted irAEs (AUC=0.753).
• Patients with irAEs showed longer progression-free survival (PFS) (P=0.001).
• irAEs were an independent factor for improved PFS (P=0.006).

Conclusions:

• Treg cell count is an independent factor influencing irAEs in advanced gastric cancer patients on PD-1 inhibitor therapy.
• The occurrence of irAEs is associated with longer PFS.
• A predictive model combining Treg count, Ki-67 index, and age (≥65 years) effectively predicts irAEs.