ABCC2-24C > T polymorphism is associated with the response to platinum/5-Fu-based neoadjuvant chemotherapy and better clinical outcomes in advanced gastric cancer patients

Background: The preoperative systemic inflammation response index (SIRI), based on peripheral neutrophil (N), monocyte (M), and lymphocyte (L) counts, has shown mounting evidence as an effective prognostic indicator in some malignant tumors. The aim of the present study was to evaluate the prognostic significance of pre-treatment SIRI in gastric cancer patients who received neoadjuvant chemotherapy (NACT).Methods: This retrospective study comprised 107 patients with advanced gastric cancer treated with NACT between July 2007 and September 2015 in our hospital. SIRI was calculated from peripheral venous blood samples obtained prior to treatment. The best cutoff value for SIRI by receiver operating characteristic (ROC) curve was 1.2 (low SIRI <1.21, high SIRI ≥1.21). The clinical outcomes of disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier survival analysis and compared using the log-rank test. Univariate and multivariate analyses were performed by the Cox proportional hazards regression model.Results: The results demonstrated that the low SIRI group was statistically associated with gender, primary tumor site, white blood cell, neutrophil, and monocyte counts, NLR (neutrophil to lymphocyte ratio), MLR (monocyte to lymphocyte ratio), and PLR (platelet to lymphocyte ratio). The SIRI was predictive for DFS and OS by univariate and multivariate analysis; the low SIRI group had better median DFS and OS than the high SIRI group (median DFS 27.03 vs. 22.33 months, median OS 29.73 vs. 24.43 months). The DFS and OS in the low SIRI group were longer than the high SIRI group.Conclusions: SIRI may qualify as a useful, reliable, and convenient prognostic indicator in patients with advanced gastric cancer to help physicians to provide personalized prognostication for gastric cancer patients treated with NACT.

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Development of a Clinical Nomogram for Prediction of Response to Neoadjuvant Chemotherapy in Patients with Advanced Gastric Cancer

10.21203/rs.3.rs-742823/v1 ◽

2021 ◽

Author(s):

Xianwen Liang ◽

Xu-Liang Liao ◽

Hua-Yang Pang ◽

Tao Pan ◽

Xiao-Hai Song ◽

...

Keyword(s):

Gastric Cancer ◽

Neoadjuvant Chemotherapy ◽

Advanced Gastric Cancer ◽

Cancer Patients ◽

Tumor Location ◽

Histological Differentiation ◽

Prediction Of Response ◽

Gastric Cancer Patients ◽

Response Group ◽

Group Grade

Abstract Objective:The efficacy of neoadjuvant chemotherapy (NAC) among advanced gastric cancer (GC) is still a controversial issue. Our aim is to find the factors associated with chemosensitivity of NAC, and provide optimal therapeutic strategy for GC patients who received NAC.Methods: Clinical information was collected from 230 gastric cancer patients who received NAC in West China Hospital from January 2016 to December 2020. LASSO logistic regression analysis was performed to find the possible predictors which a nomogram model for prediction of response to NAC was based on.Results: A total of 230 patients were finally included in this study, including 154 males (67.0%) and 76 females (33.0%). And mean age was (59.37±10.60) years, ranging from 24 to 80 years. Based on the TRG standard, there were 95 cases in the obvious response group (grade 0 or grade 1) and 135 cases in the non-obvious response group (grade 2 or grade 3), and the obvious response rate was 41.3%. LASSO analysis showed that four risk factors that were significantly related to the efficacy of NAC, which included tumor location (P<0.001) , histological differentiation (P=0.001), clinical T stage (P=0.008) , CA724 (P=0.008) . The C-index for prediction nomogram was 0.806, and the calibration curve revealed the predicted value exhibited good agreement with the actual value, decision curve analysis showed that the nomogram had a good value in clinical application.Conclusions: The nomogram which combined tumor location, histological differentiation，clinical T stage and CA724 showed satisfactory predictive power to response of NAC, and could be used by gastrointestinal surgeons to identify optimal treatment strategy for advanced gastric cancer patients.

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