Prognostic and predictive value of systemic inflammatory markers in patients with metastatic gastric and GEJ adenocarcinoma with PDL1 CPS score 5 Turkish Oncology Group TOG study summary

This episode reviews the Turkish Oncology Group TOG study, a multicenter retrospective cohort of 153 patients with metastatic gastric or GEJ adenocarcinoma and PD-L1 CPS ≥5 treated with first-line nivolumab plus chemotherapy. It evaluates baseline systemic inflammatory markers—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)—for prognostic and predictive value regarding progression-free survival (PFS) and overall survival (OS). Key findings include median PFS of 11.06 months and median OS of 16.03 months; lower baseline NLR, PLR, and SII correlated with longer outcomes in univariate analysis, with SII and PD-L1 CPS independently predicting treatment response; lung metastases associated with worse prognosis. Limitations include the retrospective, real-world design and biomarker assessment only at baseline. The episode discusses implications for integrating SII with PD-L1 CPS to refine patient selection and monitoring, and suggests directions for prospective validation and exploration of dynamic biomarker changes.