ArticleFrontiers in immunology2025
Plasma immune proteome-based risk score predicts survival in advanced gastric cancer treated with PD-1 inhibitors and chemotherapy.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Blood-based biomarkers that capture systemic immunity could complement tissue-based assays for prognostication in advanced gastric cancer receiving programmed cell death protein 1 (PD-1)-based chemoimmunotherapy. We evaluated whether baseline plasma immune proteomics can stratify clinical outcomes and be operationalized into a clinically usable model. Methods: In a prospective cohort (n=40) treated with first-line PD-1 inhibitor plus chemotherapy, nano-ultra-high-performance liquid chromatography (nano-UHPLC) coupled with Orbitrap data-independent acquisition liquid chromatography-tandem mass spectrometry (DIA LC-MS/MS) was used to profile baseline plasma. Quality control (QC)-filtered protein intensities were median-normalized, log Results: PCA showed outcome-associated separation. Differential testing identified 322 proteins (179 up, 143 down in long-term survivors), including 36 immune-related differentially expressed proteins (DEPs). Penalized modeling selected a five-protein prognostic panel-LTB4R, GBP2, HLA-G, CYBB, HLA-B. The risk score, dichotomized at the cohort median, stratified overall survival (OS) and progression-free survival (PFS) with clear separation. Time-dependent ROC area under the curve (AUC) values for OS at 6/12/18/24 months were 0.850/0.838/0.911/0.844, exceeding age, sex, grade, and programmed death-ligand 1 (PD-L1) combined positive score (CPS). In multivariable Cox models adjusting for clinical covariates, the score remained independently associated with OS. A nomogram combining the score with clinicopathologic factors yielded individualized 6-, 12-, and 18-month OS estimates with good calibration. Median PFS and OS for the overall cohort were 5.5 and 10.0 months, respectively. Conclusions: Baseline plasma immune proteomics supports a compact, interpretable five-protein risk score that augments clinicopathologic variables for prognostic stratification under PD-1-based chemoimmunotherapy. The model is amenable to targeted assay translation and prospective validation for clinical deployment.
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