Association of the CD4+/CD8+ ratio with response to PD-1 inhibitor-based combination therapy and dermatological toxicities in patients with advanced gastric and esophageal cancer

•CD4+/CD8+ ratio predict prognosis of patients with advanced GC and EC treated with PD-1 inhibitor-based combination therapy.•Nomogram incorporating CD4+/CD8+ ratio and other factors can predict OS with considerable accuracy.•CD4+/CD8+ ratio can predict the efficacy of PD-1 inhibitor-based combinati...

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Published in:International immunopharmacology 2023-10, Vol.123, p.110642-110642, Article 110642
Main Authors: Xu, Shuangwei, Zhu, Qiuwei, Wu, Lixia, Wang, Yaoyao, Wang, Jingmiao, Zhu, Lina, Zheng, Shanshan, Hang, Junjie
Format: Article
Language:English
Subjects:
CD4+/CD8+ ratio
Dermatological toxicities
Esophageal cancer
Gastric cancer
Immunotherapy
Survival
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Summary:•CD4+/CD8+ ratio predict prognosis of patients with advanced GC and EC treated with PD-1 inhibitor-based combination therapy.•Nomogram incorporating CD4+/CD8+ ratio and other factors can predict OS with considerable accuracy.•CD4+/CD8+ ratio can predict the efficacy of PD-1 inhibitor-based combination therapy.•CD4+/CD8+ ratio can independently predict dermatologic toxicities caused by PD-1 inhibitor-based combination therapy. The host immune system affects the treatment response to immune checkpoint inhibitors and can be reflected by circulating immune cells. This study aimed to evaluate whether circulating T cell subtypes are correlated with clinical response and dermatological toxicities in patients with advanced gastric and esophageal cancer receiving PD-1 inhibitor-based combination therapy (n = 203). In the training cohort, Eastern Cooperative Oncology Group performance status (ECOG PS), PD-L1 expression, antibiotic use, and CD4+/CD8+ ratio were identified as independent prognostic factors in these patients, using a Cox regression model. A nomogram to predict the overall survival (OS) and survival probabilities was constructed using these factors. The nomogram showed good discrimination ability (C-index, 0.767) and was externally confirmed in the validation and test cohorts. Kaplan-Meier analysis showed that median OS in patients with a CD4+/CD8+ ratio ≥1.10 was 6.2 months, which was significantly shorter than that in patients with a CD4+/CD8+ ratio
ISSN:1567-5769
1878-1705
DOI:10.1016/j.intimp.2023.110642