Treatment-dependent and independent prognostic value of inflammation-based nutritional indices in immune checkpoint inhibitor-based therapy for esophageal cancer
- 1Department of Gastroenterological Surgery, Graduate School of Medicine, The University of Osaka, 2-2-E2, Yamada-Oka, Suita, Osaka, 565-0871 Japan
- 2Department of Surgery, NHO Osaka National Hospital, Osaka, Japan
- 3Department of Surgery, Osaka General Medical Center, Osaka, Japan
Abstract
Background: Phase III trials have established the efficacy of immune-based therapies for unresectable advanced or recurrent esophageal squamous cell carcinoma (ESCC). However, real-world evidence comparing regimens and clinically applicable prognostic biomarkers remains limited.
Methods: We retrospectively evaluated 245 patients with unresectable advanced/recurrent ESCC treated with first-line 5-fluorouracil plus cisplatin combined with nivolumab or pembrolizumab (CF + ICI; n = 114), first-line ipilimumab plus nivolumab (Ipi + Nivo; n = 46), or nivolumab monotherapy as second-line or later treatment (Nivo; n = 85). Efficacy, safety, and survival outcomes were assessed, focusing on inflammation-based nutritional indices and multivariate prognostic modelling.
Results: The objective response rates were 56%, 53%, and 27%, and the median overall survival was 26, 73, and 13 months in the CF + ICI, Ipi + Nivo, and Nivo groups, respectively. No treatment-related deaths occurred. In multivariate analyses, Glasgow Prognostic Score (GPS) ≥ 2 independently predicted poor survival across all regimens. High platelet-to-lymphocyte ratio (PLR) was independently associated with poor survival only in chemotherapy-free ICI regimens (Ipi + Nivo and Nivo). A pooled model showed a significant interaction between treatment regimen and PLR (p = 0.047).
Conclusions: In real-world practice, GPS provides regimen-independent prognostic stratification, whereas PLR shows treatment-dependent prognostic relevance, supporting its potential utility for biomarker-guided and individualized treatment selection in ESCC.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01243-x.
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BibTeX
@article{matsuda2026treatmentdependent,
title = {{Treatment-dependent and independent prognostic value of inflammation-based nutritional indices in immune checkpoint inhibitor-based therapy for esophageal cancer}},
author = {Hiroki Matsuda and Tomoki Makino and Shuichiro Hara and Shigeto Nakai and Takaomi Hagi and Kota Momose and Kotaro Yamashita and Takuro Saito and Koji Tanaka and Atsushi Takeno and Tsuyoshi Takahashi and Masaaki Motoori and Yukinori Kurokawa and Hidetoshi Eguchi and Yuichiro Doki},
journal = {Esophagus},
year = {2026},
month = aug,
doi = {10.1007/s10388-026-01243-x},
url = {https://doi.org/10.1007/s10388-026-01243-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Treatment-dependent and independent prognostic value of inflammation-based nutritional indices in immune checkpoint inhibitor-based therapy for esophageal cancer
AU - Hiroki Matsuda
AU - Tomoki Makino
AU - Shuichiro Hara
AU - Shigeto Nakai
AU - Takaomi Hagi
AU - Kota Momose
AU - Kotaro Yamashita
AU - Takuro Saito
AU - Koji Tanaka
AU - Atsushi Takeno
AU - Tsuyoshi Takahashi
AU - Masaaki Motoori
AU - Yukinori Kurokawa
AU - Hidetoshi Eguchi
AU - Yuichiro Doki
PY - 2026
DA - 2026/08/28
JO - Esophagus
DO - 10.1007/s10388-026-01243-x
UR - https://doi.org/10.1007/s10388-026-01243-x
AB - Background: Phase III trials have established the efficacy of immune-based therapies for unresectable advanced or recurrent esophageal squamous cell carcinoma (ESCC). However, real-world evidence comparing regimens and clinically applicable prognostic biomarkers remains limited. Methods: We retrospectively evaluated 245 patients with unresectable advanced/recurrent ESCC treated with first-line 5-fluorouracil plus cisplatin combined with nivolumab or pembrolizumab (CF + ICI; n = 114), first-line ipilimumab plus nivolumab (Ipi + Nivo; n = 46), or nivolumab monotherapy as second-line or later treatment (Nivo; n = 85). Efficacy, safety, and survival outcomes were assessed, focusing on inflammation-based nutritional indices and multivariate prognostic modelling. Results: The objective response rates were 56%, 53%, and 27%, and the median overall survival was 26, 73, and 13 months in the CF + ICI, Ipi + Nivo, and Nivo groups, respectively. No treatment-related deaths occurred. In multivariate analyses, Glasgow Prognostic Score (GPS) ≥ 2 independently predicted poor survival across all regimens. High platelet-to-lymphocyte ratio (PLR) was independently associated with poor survival only in chemotherapy-free ICI regimens (Ipi + Nivo and Nivo). A pooled model showed a significant interaction between treatment regimen and PLR (p = 0.047). Conclusions: In real-world practice, GPS provides regimen-independent prognostic stratification, whereas PLR shows treatment-dependent prognostic relevance, supporting its potential utility for biomarker-guided and individualized treatment selection in ESCC. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01243-x.
SN - 1612-9059
SN - 1612-9067
ER -