scholarly journals Predictive Value of Albumin and Neutrophil Combined Prognostic Grade in Advanced Gastric Cancer Patients Treated With anti-PD-1 Therapy

2021 ◽  
Author(s):  
Yuting Pan ◽  
ZhiKuan Wang ◽  
Guanghai Dai
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Predictive Value ◽  
Intermediate Group ◽  
Risk Of Death ◽  
The Poor ◽  
Good Group ◽  
Poor Group ◽  
Risk Of Disease

Abstract Background The application of immunotherapy is gradually increasing in advanced gastric cancer (AGC), but only some patients could benefit from it. Validated biomarkers can screen out the beneficiaries. The objective of this research is to explore the predictive value of albumin and neutrophil combined prognostic grade ( ANPG) in AGC patients receiving immunotherapy. Methods A total number of 268 AGC patients were included. The cut-off value of albumin was 38 g/L obtained by the median value, and neutrophil was 4.16 g/L estimated by the average value. The high levels of albumin (≥38 g/L) and neutrophil (≥4.16 g/L) were considered to be two risk factors for ANPG. Based on these two risk factors, patients were categorized into 3 groups：the risk factor number for the "good" group was 0, for the "intermediate" group was 1, and for the "poor" group was 2. Results Patients with the good ANPG was related to longer progression free survival (PFS) and overall survival (OS), compared to those with the intermediate and the poor ANPG (5.6 months vs 5.3 months vs 3.4 months, 17.8 months vs 11.8 months vs 8.2 months). The poor group was independently correlated with an over 1.9 times risk of disease progression (HR=1.901; 95% CI, 1.314-2.750; P=0.001) and an over 2 times risk of death (HR=2.003; 95% CI, 1.306-3.072; P=0.001) than the good group. The intermediate group was independently correlated with an over 1.3 times risk of disease progression (HR=1.385; 95% CI, 1.004-1.911; P=0.048) and an over 1.4 times risk of death (HR=1.484; 95% CI, 1.046-2.106; P=0.027) than the good group. Conclusion Our study verifies, for the first time, that ANPG is an independent factor affecting survival of AGC patients receiving immunotherapy. Patients with the good ANPG could benefit from immunotherapy.

scholarly journals Efficacy and safety of nivolumab for advanced gastric cancer patients with poor performance statuses

2020 ◽  
Author(s):  
Toshihiko Matsumoto ◽  
Yosuke Yamamoto ◽  
Yusuke Kurioka ◽  
Ukyo Okazaki ◽  
Shogo Kimura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Advanced Gastric Cancer ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Efficacy And Safety ◽  
The Poor ◽  
Good Group ◽  
Poor Group

Abstract Background: Nivolumab has changed the treatment of advanced gastric cancer (AGC). Nivolumab shows better outcomes compared to best supportive care among AGC patients who received at least two prior regimens. However, there are no reliable data regarding AGC patients with poor performance status (PS) who received nivolumab. We investigated the efficacy and safety of nivolumab among AGC patients with poor PS. Methods: We retrospectively collected clinicopathologic data from patients with AGC who underwent nivolumab monotherapy at our institution from October 2017 to June 2019. Results: Forty-nine AGC patients who received nivolumab were assessed. Twenty-seven patients had PS 0 or 1 (Good group) and 22 had PS 2 or 3 (Poor group). The median progression-free survival and overall survival durations were 61 and 180 days in the Good group, respectively, and 36 and 85 days in the Poor group, respectively. The overall survival was significantly shorter in the Poor group (180 vs 85 days, p =0.0255). The disease control rates were 23% and 9% in the Good and Poor groups, respectively. Thirty-three percent of patients experienced immune-related adverse events in the Good group, and 18% in the Poor group. Conclusion: Nivolumab has a modest effect and is feasible as third- or later-line treatment for AGC patients.

Prognostic factor of nivolumab for advanced gastric cancer patients with poor performance status patients.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 391-391
Author(s):  
Toshihiko Matsumoto ◽  
Ukyo Okazaki ◽  
Yusuke Kurioka ◽  
Shogo Kimura ◽  
Takao Tsuzuki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Advanced Gastric Cancer ◽  
Performance Status ◽  
Prognostic Index ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Good Group ◽  
Poor Group

391 Background: Nivolumab has changed the treatment of advanced gastric cancer (AGC). Nivolumab shows better outcome compared to best supportive care in AGC patients who received at least two prior regimen. Although there is not reliable date of poor performance status(PS) AGC patients who received nivolumab. We investigated efficacy and safety of nivolumab for AGC patients with poor PS. Methods: We retrospectively collected clinicopathologic data from patients with AGC who received nivolumab monotherapy in Himeji Red Cross Hospital from October 2017 to June 2019. Results: 49 AGC patients who received nivolumab were analyzed. 27 patients were PS 0 or 1(Good Group), and 22 patients were PS 2 or 3(Poor Group). Median progression free survival and overall survival was 61 days and 180 days in Good Group and 36 days and 85 days in Poor Group. Overall survival (OS) was significantly shorter in Poor group(180 days vs 85 days, p = 0.0255). Disease control rate was 23% in Good group and 9% in Poor group. 33% patients were experienced immune related adverse event (iRAE) in Good Group, and 18% in Poor Group. We investigated prognostic factor of OS in Poor Group such as Royal Marsden Hospital Score(RMH score), modified Glasgow prognostic score(mGPS), and Japan Clinical Oncology Group (JCOG) prognostic index. RMH score and JCOG prognostic index good or moderate group was significantly longer overall survival than poor group (93 days vs 35 days (p = 0.0214)). JCOG prognostic index was most correlated with OS among these tools. Conclusions: This study suggested that nivolumab has a modest effect and is feasible as third line or later line for AGC patients. JCOG prognostic index was suggested to be effective in predicting prognosis in AGC patients who received nivolumab.

scholarly journals Tu1327 – Risk Factors of Early and Advanced Gastric Cancer: A 8 Years Population Study in Northern Italy

2019 ◽  
Vol 156 (6) ◽  
pp. S-1027
Author(s):  
Chiara Miraglia ◽  
Ottavia Cavatorta ◽  
Marilisa Franceschi ◽  
Pellegrino Crafa ◽  
Gianluca Baldassarre ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Population Study ◽  
Northern Italy

scholarly journals New approaches to prediction and treatment of advanced gastric cancer based on molecular-biological parameters

2017 ◽  
Vol 94 (11) ◽  
pp. 812-820
Author(s):  
Evgeniya S. Fedoseeva ◽  
M. V. Savostikova ◽  
M. N. Narimanov ◽  
A. A. Pashaev ◽  
S. S. Kirichenko ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Predictive Value ◽  
Biological Parameters ◽  
Hereditary Predisposition ◽  
New Approaches ◽  
Brca 1 ◽  
Neoplastic Process

This review is designed to discuss possibilities for the treatment of advanced gastric cancer with reference to the prognostic and predictive value of molecular-biological parameters and the influence of hereditary predisposition to the development of neoplastic process. The data on modern pharmacotherapy of this disease based on the knowledge of molecular-biological parameters are presented including the following markers: HER2/neu, VGFR, c-met, TUBB3, CDH-1, BRCA-1, EGFR, TGF-ß, p53, Ki67 and PCNA. It is emphasized that the role of molecular-biological parameters associated with advanced gastric cancer is ambiguous. The prognostic and predictive significance of some of the markers is confirmed while that of others remains to be elucidated and requires further research.

T01.01.24 RISK FACTORS OF EARLY AND ADVANCED GASTRIC CANCER: A 8 YEARS POPULATION STUDY IN NORTHERN ITALY

2020 ◽  
Vol 52 ◽  
pp. S62
Author(s):  
O. Cavatorta ◽  
C. Miraglia ◽  
M. Franceschi ◽  
P. Crafa ◽  
G. Baldassarre ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Population Study ◽  
Northern Italy

Treatment sequence, hospital practice patterns, and completion of multimodality therapy for locally advanced gastric cancer.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 14-14
Author(s):  
Jorge Ignacio Portuondo ◽  
Hop Sanderson Tran Cao ◽  
Nader Nabile Massarweh
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Multimodality Therapy ◽  
Practice Pattern ◽  
Hospital Practice ◽  
Risk Of Death ◽  
Patient Level ◽  
Locally Advanced Gastric Cancer ◽  
Surgery First

14 Background: Optimal oncologic care for patients with locally advanced gastric cancer includes multimodality therapy (MMT). While both perioperative chemotherapy and postoperative chemoradiotherapy are recommended, it is unclear whether one approach is more effective for ensuring patients complete MMT. Methods: National cohort study of 5,450 patients with locally advanced gastric cancer (i.e.: ≥cT2 and/or cN+) treated at 983 hospitals within the National Cancer Data Base (2006-15). Patients were categorized as having surgery first or chemotherapy first (patients not undergoing resection after chemotherapy or not receiving adjuvant after surgery were included based on intent-to-treat). MMT was defined as surgical resection with either neoadjuvant chemotherapy or adjuvant chemoradiotherapy. Hospitals were categorized into terciles based on utilization of chemotherapy first: 1.) predominantly chemotherapy first; 2.) mixed pattern; 2.) predominantly surgery first. The association between patient-level treatment, hospital practice pattern, and MMT completion was evaluated using multivariable hierarchical regression and the association with overall risk of death using multivariable Cox shared frailty modeling. Results: Overall, 55.5% of surgery first and 64.8% of chemotherapy first patients completed MMT (p<0.001) and five-year survival for those completing MMT was 45.5% and 46.6%, respectively (log-rank, p=0.91). At the patient-level, chemotherapy first was significantly associated with MMT completion (Odds Ratio [OR] 1.61 [1.39– 1.86]). By comparison, relative to mixed hospitals, care at surgery first hospitals was associated with MMT completion (OR 1.32 [1.08 – 1.59]), which was due to differences in case-mix and the proportion of patients not receiving resection after chemotherapy (surgery first hospitals—4.1%; mixed hospitals—19.0%; chemotherapy first hospitals—29.4%, p<0.001). MMT by either approach was associated with lower risk of death (ref—surgery only; chemotherapy first – Hazard Ratio [HR] 0.77 [0.68 – 0.86]; surgery first – HR 0.77 [0.68 – 0.87]) while hospital practice pattern was not. Conclusions: The type of MMT strategy is less important than ensuring patients complete MMT. After accounting for treatment drop-outs (which are substantial with either strategy), chemotherapy first appears more effective in the general community for ensuring patients complete MMT. National guidelines should be modified to emphasize neoadjuvant over surgery first MMT strategies.

scholarly journals Cumulative incidence, risk factors and prognostic impact of venous thromboembolism in Japanese patients with advanced gastric cancer

2017 ◽  
Vol 47 (10) ◽  
pp. 942-948 ◽  
Author(s):  
Hiroyuki Arai ◽  
Shuichi Hironaka ◽  
Keiko Minashi ◽  
Tadamichi Denda ◽  
Mototsugu Shimokawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Venous Thromboembolism ◽  
Advanced Gastric Cancer ◽  
Cumulative Incidence ◽  
Japanese Patients ◽  
Prognostic Impact ◽  
Incidence Risk

scholarly journals Predictive Value of MPV and Plasma NT-ProBNP Combined with the Simplified Geneva Scale for the Prognosis of Acute Pulmonary Embolism

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jing Wang ◽  
Lu Wang ◽  
Ling Jin ◽  
Xiaolei Rong ◽  
Xueshuang Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Value ◽  
Poor Prognosis ◽  
Acute Pulmonary Embolism ◽  
Good Prognosis ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
The Poor ◽  
Prognosis Group ◽  
Good Prognosis Group

Objective. To explore the predictive value of mean platelet volume (MPV) and plasma N-terminal probrain natriuretic peptide (NT-ProBNP) combined with a simplified Geneva scale for the prognosis of acute pulmonary embolism (APE). Methods. The clinical data of 68 patients with APE admitted to our hospital from October 2017 to October 2019 were collected. According to the prognosis, the patients were divided into a good prognosis group (n = 45) and a poor prognosis group (n = 23). The clinical data, laboratory clinical indexes, and simplified Geneva scale scores were recorded for the two groups. The risk factors of poor prognosis were analyzed by binary multivariate logistic regression analysis; the predictive ability of each index on the prognosis of patients with APE was analyzed by the ROC curve. Results. The incidences of deep vein thrombosis, diabetes, and hyperlipidemia in the poor prognosis group were higher than those in the good prognosis group ( P < 0.05 ). PLT, platelet distribution width (PDW), MPV, and plasma NT-ProBNP in the poor prognosis group were higher than those in the good prognosis group ( P < 0.05 ). The simplified Geneva scale score of the poor prognosis group was higher than that of the good prognosis group ( P < 0.05 ). PDW, MPV, plasma NT-ProBNP, and simplified Geneva scale were all independent risk factors for the poor prognosis of APE patients ( P < 0.05 ). The AUC of MPV in predicting the prognosis of APE patients was 0.818 (95% CI: 0.712–0.925). When the optimal cutoff value was 0.571, the sensitivity was 77.1%, and the specificity was 80.0%. The AUC of plasma NT-ProBNP in predicting the prognosis of APE patients was 0.762 (95% CI: 0.634–0.891). When the optimal cutoff value was 0.475, the sensitivity was 71.5%, and the specificity was 76.0%. The AUC of the simplified Geneva scale in predicting the prognosis of APE patients was 0.749 (95% CI: 0.618–0.879). When the optimal cutoff value was 0.469, the sensitivity was 82.9%, and the specificity was 64.0%. The AUC of MPV and plasma NT-ProBNP combined with the simplified Geneva scale in predicting the prognosis of APE patients was 0.907 (95% CI: 0.826–0.988). When the optimal cutoff value was 0.726, the sensitivity was 88.6%, and the specificity was 84.0%. Conclusion. MPV, plasma NT-ProBNP, and simplified Geneva scale have a certain predictive value for the prognosis of APE. Compared with a single index, the combination of the three indexes has a significant improvement in predicting the prognosis of APE and has better clinical value.

scholarly journals Association Between DCE-MRI Perfusion Histogram Parameters and EGFR and VEGF Expressions in Different Lauren Classifications of Advanced Gastric Cancer

2022 ◽  
Vol 27 ◽  
Author(s):  
Zhiheng Li ◽  
Zhenhua Zhao ◽  
Chuchu Wang ◽  
Dandan Wang ◽  
Haijia Mao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Growth Factor ◽  
Advanced Gastric Cancer ◽  
Predictive Value ◽  
Intestinal Type ◽  
Imaging Biomarkers ◽  
Diffuse Type ◽  
Vegf Expression ◽  
Dce Mri ◽  
Sensitivity Specificity

Objective: To investigate the correlations between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) perfusion histogram parameters and vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) expressions in advanced gastric cancer (AGC).Methods: This retrospective study included 80 pathologically confirmed patients with AGC who underwent DCE-MRI before surgery from February 2017 to May 2021. The DCE-MRI perfusion histogram parameters were calculated by Omni Kinetics software in four quantitative parameter maps. Immunohistochemical methods were used to detect VEGF and EGFR expressions and calculate the immunohistochemical score.Results: VEGF expression was relatively lower in patients with intestinal-type AGC than those with diffuse-type AGC (p &lt; 0.05). For VEGF, Receiver operating characteristics (ROC) curve analysis revealed that Quantile 90 of Ktrans, Meanvalue of Kep and Quantile 50 of Ve provided the perfect combination of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for distinguishing high and low VEGF expression, For EGFR, Skewness of Ktrans, Energy of Kep and Entropy of Vp provided the perfect combination of sensitivity, specificity, PPV and NPV for distinguishing high and low EGFR expression. Ktrans (Quantile 90, Entropy) showed the strongest correlation with VEGF and EGFR in patients with intestinal-type AGC (r = 0.854 and r = 0.627, respectively); Ktrans (Mean value, Entropy) had the strongest correlation with VEGF and EGFR in patients with diffuse-type AGC (r = 0.635 and 0.656, respectively).Conclusion: DCE-MRI perfusion histogram parameters can serve as imaging biomarkers to reflect VEGF and EGFR expressions and estimate their difference in different Lauren classifications of AGC.

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