Journal of Shanghai Jiao Tong University (Medical Science) >

2022 , Vol. 42 >Issue 8: 1053 - 1061

DOI: https://doi.org/10.3969/j.issn.1674-8115.2022.08.010

Clinical research

Related factors and prognostic analysis of adverse events of immunotherapy in advanced gastric cancer

  • Ting HAN ,
  • Chunxin Lü ,
  • Meng ZHUO ,
  • Qing XIA ,
  • Tengfei LIU ,
  • Xiuqi WU ,
  • Xiaolin LIN ,
  • Xiuying XIAO
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  • 1.Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    2.Department of Oncology, Punan Hospital of Pudong New District, Shanghai 200120, China
LIN Xiaolin, E-mail: renjilxl@163.com。
XIAO Xiuying, E-mail: xiaoxiuying2002@163.com

Received date: 2022-03-11

  Accepted date: 2022-07-03

  Online published: 2022-08-12

Supported by

National Natural Science Foundation of China(81874048)

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Abstract

Objective ·To explore the characteristics and predictive factors of immune-related adverse events (irAEs) in advanced gastric cancer patients treated with programmed death-1 (PD-1) inhibitors, and analyze the correlation between irAEs and prognosis. Methods ·A total of 140 patients with advanced gastric cancer treated with PD-1 inhibitors in Renji Hospital, Shanghai Jiao Tong University School of Medicine from June 2018 to October 2021 were selected. They were divided into irAEs group and non-irAEs group according to whether they had irAEs or not. The clinical characteristics, irAEs occurrence and prognosis of the patients in the two groups were collected and analyzed. Multivariate Logistic regression model was used to analyze the related factors affecting the occurrence of irAEs, and the prediction model of irAEs was established. The receiver operating characteristic curve (ROC curve) was used to evaluate the ability of different indicators to predict the occurrence of irAEs. Kaplan-Meier survival curve was used to analyze the correlation between irAEs and prognosis. Cox proportional hazard model was used to analyze the related factors affecting the prognosis of patients. Results ·A total of 132 patients completed the follow-up, of which 63 patients (47.7%) developed irAEs. In the comparison of clinical characteristics between the groups, it was found that there were statistically significant differences in age≥65 years, Ki-67 index, leukocyte count, neutrophil count and regulatory T cell (Treg) count (all P<0.05). Multivariate Logistic regression analysis showed that Treg count was the protective factor for affecting the occurrence of irAEs (P=0.030). ROC curve showed that the combined index of Treg+Ki-67+Age (≥65 years) could better predict the occurrence of irAEs (AUC=0.753, 95% CI 0.623?0.848, P=0.000). Kaplan-Meier survival curve showed that the progression-free survival (PFS) of patients in the irAEs group was longer than that in the non-irAEs group (P=0.001). Cox proportional hazard regression analysis showed that irAEs was an independent influencing factor of PFS (P=0.006). Conclusion ·Treg count is an independent influencing factor for the occurrence of irAEs in patients with advanced gastric cancer undergoing PD-1 inhibitor immunotherapy, and its occurrence can prolong the PFS of patients. The combined index of Treg+Ki-67+Age (≥65 years) can better predict the occurrence of irAEs.

Key words： advanced gastric cancer; immune checkpoint inhibitor (ICI); regulatory T cell (Treg); receiver operating characteristic curve (ROC curve)

Cite this article

Ting HAN , Chunxin Lü , Meng ZHUO , Qing XIA , Tengfei LIU , Xiuqi WU , Xiaolin LIN , Xiuying XIAO . Related factors and prognostic analysis of adverse events of immunotherapy in advanced gastric cancer[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022 , 42(8) : 1053 -1061 . DOI: 10.3969/j.issn.1674-8115.2022.08.010

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