Highlights
- •A prognostic impact of soluble forms of programmed cell death ligand 1 (sPD-L1) was demonstrated for nivolumab-treated gastric cancer.
- •Both sPD-L1 and Glasgow prognostic score were independently associated with overall survival.
- •The prognostic accuracy of sPD-L1 was improved by its combination with Glasgow prognostic score.
Abstract
Background
The clinical value of soluble forms of programmed cell death–1 (sPD-1), PD ligand
1 (sPD-L1) and cytotoxic T lymphocyte–associated protein–4 (sCTLA-4) for gastric cancer
(GC) patients treated with nivolumab monotherapy has remained unknown.
Methods
Blood samples collected before nivolumab treatment from 439 GC patients enrolled in
the DELIVER (Japan Clinical Cancer Research Organisation GC-08) trial were analysed
for sPD-1, sPD-L1 and sCTLA-4. Corresponding baseline clinical data were also retrieved.
Results
Higher plasma levels of sPD-1 (hazard ratio [HR] = 1.27, p = 0.020), sPD-L1 (HR = 1.86, p < 0.001) and sCTLA-4 (HR = 1.33, p = 0.008) were significantly associated with shorter overall survival (OS), whereas
only higher sPD-L1 levels was significantly associated with shorter progression-free
survival (HR = 1.30, p = 0.008). The sPD-L1 concentration was significantly associated with the Glasgow
prognostic score (GPS) (p < 0.001), but both sPD-L1 (HR = 1.67, p < 0.001) and GPS (HR = 1.39, p = 0.009 for GPS 0 versus 1; HR = 1.95, p < 0.001 for GPS 0 versus 2) were independently associated with OS. Patients with
a GPS of 0 and low sPD-L1 thus showed the longest OS (median, 12.0 months) and those
with a GPS of 2 and high sPD-L1 showed the shortest OS (median, 3.1 months), yielding
a HR of 3.69 (p < 0.001).
Conclusion
Baseline sPD-L1 levels have the potential to predict survival for advanced GC patients
treated with nivolumab, with the prognostic accuracy of sPD-L1 being improved by its
combination with GPS.
Keywords
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Article info
Publication history
Published online: February 09, 2023
Accepted:
February 2,
2023
Received in revised form:
January 24,
2023
Received:
October 21,
2022
Footnotes
☆This study was presented at the World Congress on Gastrointestinal Cancer 2022 in Barcelona on 30 June 2022.
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
