The CALLY Index for Unresectable or Recurrent Gastric Cancer Treated With Nivolumab: A Multicenter Retrospective Study.
4 affiliations
- 1Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan. [email protected].
- 2Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
- 3Department of Surgery, The Jikei University Katsushika Medical Center, Tokyo, Japan.
- 4Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Japan.
Abstract
Purpose
The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel immuno-nutritional marker in various cancers. We investigated its prognostic value in patients with unresectable or recurrent gastric cancer who were treated with nivolumab monotherapy.Materials and methods
This multicenter retrospective study included 126 patients treated with third- or later-line nivolumab monotherapy. The CALLY index was calculated as (Albumin × Lymphocyte Count)/(C-Reactive Protein × 10⁴) and dichotomized at 1.08. The operating characteristics of this cutoff were evaluated using receiver operating characteristic analysis for 1-year overall survival (OS). OS and progression-free survival (PFS) were evaluated.Results
The CALLY-low group exhibited a significantly shorter median OS (164 vs. 377 days; P=0.004) and median PFS (56 vs. 104 days; P<0.001) than the CALLY-high group. In multivariable models from which posttreatment immune-related adverse events were excluded, the CALLY index was an independent prognostic factor for both OS (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.31-3.21; P=0.002) and PFS (HR, 2.00; 95% CI, 1.33-3.02; P<0.001) after adjustment for clinically relevant factors.Conclusions
The pretreatment CALLY index was an independent prognostic biomarker for both OS and PFS in patients with unresectable or recurrent gastric cancer receiving third- or later-line nivolumab monotherapy. By integrating the C-reactive protein levels, albumin levels, and lymphocyte counts, the CALLY index may serve as a practical tool for pretreatment risk stratification in this setting.
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BibTeX
@article{takeshita2026cally,
title = {{The CALLY Index for Unresectable or Recurrent Gastric Cancer Treated With Nivolumab: A Multicenter Retrospective Study.}},
author = {Kenji Takeshita and Muneharu Fujisaki and Motohiro Shionozaki and Kazuhide Sato and Mizuki Fukuda and Naoko Fukushima and Yoshitaka Ishikawa and Yuta Takano and Fumiaki Yano and Ken Eto},
journal = {Journal of gastric cancer},
year = {2026},
month = oct,
doi = {10.5230/jgc.2026.26.e46},
url = {https://europepmc.org/article/MED/42845259},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - The CALLY Index for Unresectable or Recurrent Gastric Cancer Treated With Nivolumab: A Multicenter Retrospective Study.
AU - Kenji Takeshita
AU - Muneharu Fujisaki
AU - Motohiro Shionozaki
AU - Kazuhide Sato
AU - Mizuki Fukuda
AU - Naoko Fukushima
AU - Yoshitaka Ishikawa
AU - Yuta Takano
AU - Fumiaki Yano
AU - Ken Eto
PY - 2026
DA - 2026/10/01
JO - Journal of gastric cancer
DO - 10.5230/jgc.2026.26.e46
UR - https://europepmc.org/article/MED/42845259
AB - Purpose The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel immuno-nutritional marker in various cancers. We investigated its prognostic value in patients with unresectable or recurrent gastric cancer who were treated with nivolumab monotherapy.Materials and methods This multicenter retrospective study included 126 patients treated with third- or later-line nivolumab monotherapy. The CALLY index was calculated as (Albumin × Lymphocyte Count)/(C-Reactive Protein × 10⁴) and dichotomized at 1.08. The operating characteristics of this cutoff were evaluated using receiver operating characteristic analysis for 1-year overall survival (OS). OS and progression-free survival (PFS) were evaluated.Results The CALLY-low group exhibited a significantly shorter median OS (164 vs. 377 days; P=0.004) and median PFS (56 vs. 104 days; P<0.001) than the CALLY-high group. In multivariable models from which posttreatment immune-related adverse events were excluded, the CALLY index was an independent prognostic factor for both OS (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.31-3.21; P=0.002) and PFS (HR, 2.00; 95% CI, 1.33-3.02; P<0.001) after adjustment for clinically relevant factors.Conclusions The pretreatment CALLY index was an independent prognostic biomarker for both OS and PFS in patients with unresectable or recurrent gastric cancer receiving third- or later-line nivolumab monotherapy. By integrating the C-reactive protein levels, albumin levels, and lymphocyte counts, the CALLY index may serve as a practical tool for pretreatment risk stratification in this setting.
SN - 2093-582X
SN - 2093-5641
ER -