Prognostic Value of Early Weight Gain in Patients With Stage IV Gastric Cancer Undergoing First-Line Combination Immunotherapy.
9 affiliations
- 1Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
- 2Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumors, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
- 3Cancer Center of Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
- 4Medical Imaging Department, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
- 5Department of Pathology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
- 6Guangdong Province Key Laboratory of Molecular Tumor Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China. [email protected].
- 7Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumors, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. [email protected].
- 8Cancer Center of Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China. [email protected].
- 9Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumors, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. [email protected].
Abstract
Purpose
Conventional radiologic assessment using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) may not fully capture clinical responses during immunotherapy. Therefore, we investigated the association between early weight gain (WG) and prognosis in this population.Materials and methods
We enrolled 268 consecutive patients with stage IV gastric cancer (GC) who received first-line combination immunotherapy. Data were obtained from a prospective clinical database. Cox regression and g-computation were used to quantify and visualize the associations between WG and progression-free survival (PFS) and overall survival (OS). The skeletal muscle index (SMI), subcutaneous fat index (SFI), and visceral fat index (VFI) at L3 were calculated using 3D Slicer.Results
After a median follow-up of 29.7 months, 210 (78.3%) patients experienced disease progression and 185 (69.0%) died. The median overall survival (mOS) was 14.8 months, and the median progression-free survival (mPFS) was 7.2 months. The optimal cutoff value for WG was 4%, classifying patients into the WG ≥4% (n=87) and WG <4% (n=181) groups. WG ≥4% was associated with longer mOS (hazard ratio [HR], 0.225; P<0.001) and mPFS (HR, 0.449; P<0.001). WG ≥4% was also significantly associated with prolonged mOS in patients with stable disease (SD) (HR, 0.140; P<0.001) and progressive disease (PD) (HR, 0.045; P=0.003). Multivariate Cox regression analysis confirmed WG as an independent predictor of survival outcomes. SFI (r=0.34) and SMI (r=0.32) were moderately and positively correlated with OS.Conclusions
WG ≥4% is associated with better survival outcomes in patients with stage IV GC undergoing combination immunotherapy, even in those with SD or PD.
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BibTeX
@article{huang2026prognostic,
title = {{Prognostic Value of Early Weight Gain in Patients With Stage IV Gastric Cancer Undergoing First-Line Combination Immunotherapy.}},
author = {Kaihua Huang and Min Lai and Huiming Zhang and Huayuan Liang and Xiao Yan and Qingling Yu and Huilin Huang and Rou Zhong and Qing Xie and Xinru Liu and Zhiwei Li and Lina Yu and Hao Liu and Guoxin Li and Liying Zhao},
journal = {Journal of gastric cancer},
year = {2026},
month = oct,
doi = {10.5230/jgc.2026.26.e43},
url = {https://europepmc.org/article/MED/42845256},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Prognostic Value of Early Weight Gain in Patients With Stage IV Gastric Cancer Undergoing First-Line Combination Immunotherapy.
AU - Kaihua Huang
AU - Min Lai
AU - Huiming Zhang
AU - Huayuan Liang
AU - Xiao Yan
AU - Qingling Yu
AU - Huilin Huang
AU - Rou Zhong
AU - Qing Xie
AU - Xinru Liu
AU - Zhiwei Li
AU - Lina Yu
AU - Hao Liu
AU - Guoxin Li
AU - Liying Zhao
PY - 2026
DA - 2026/10/01
JO - Journal of gastric cancer
DO - 10.5230/jgc.2026.26.e43
UR - https://europepmc.org/article/MED/42845256
AB - Purpose Conventional radiologic assessment using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) may not fully capture clinical responses during immunotherapy. Therefore, we investigated the association between early weight gain (WG) and prognosis in this population.Materials and methods We enrolled 268 consecutive patients with stage IV gastric cancer (GC) who received first-line combination immunotherapy. Data were obtained from a prospective clinical database. Cox regression and g-computation were used to quantify and visualize the associations between WG and progression-free survival (PFS) and overall survival (OS). The skeletal muscle index (SMI), subcutaneous fat index (SFI), and visceral fat index (VFI) at L3 were calculated using 3D Slicer.Results After a median follow-up of 29.7 months, 210 (78.3%) patients experienced disease progression and 185 (69.0%) died. The median overall survival (mOS) was 14.8 months, and the median progression-free survival (mPFS) was 7.2 months. The optimal cutoff value for WG was 4%, classifying patients into the WG ≥4% (n=87) and WG <4% (n=181) groups. WG ≥4% was associated with longer mOS (hazard ratio [HR], 0.225; P<0.001) and mPFS (HR, 0.449; P<0.001). WG ≥4% was also significantly associated with prolonged mOS in patients with stable disease (SD) (HR, 0.140; P<0.001) and progressive disease (PD) (HR, 0.045; P=0.003). Multivariate Cox regression analysis confirmed WG as an independent predictor of survival outcomes. SFI (r=0.34) and SMI (r=0.32) were moderately and positively correlated with OS.Conclusions WG ≥4% is associated with better survival outcomes in patients with stage IV GC undergoing combination immunotherapy, even in those with SD or PD.
SN - 2093-582X
SN - 2093-5641
ER -