ArticleFrontiers in immunology2026
Hematological biomarkers for predicting pathologic response to neoadjuvant immunochemotherapy and cycle optimization in locally advanced gastric cancer.
Article in Frontiers in immunology, 2026. 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: The predictive value of hematological parameters for pathologic response to neoadjuvant immunochemotherapy (NICT) in locally advanced gastric cancer (LAGC) remains unclear. Methods: This retrospective study consecutively enrolled 246 LAGC patients who received NICT followed by radical gastrectomy at The First Hospital of Lanzhou University (2021-2024). Based on postoperative pathology, patients were classified into major pathologic response (MPR, tumor regression grade [TRG] 1a/1b, residual tumor ≤10%) and incomplete pathologic response (IPR, TRG 2/3, residual tumor >10%) groups. Hematological parameters pre- and post-treatment were analyzed. Logistic regression and receiver operating characteristic (ROC) analyses were employed (statistical significance: p<0.05). Results: Multivariate analysis identified pre-treatment neutrophil count (Neutrophil_pre) (adjusted odds ratio [OR]: 0.83, 95% CI: 0.70-0.99, P = 0.033) and post-treatment albumin (ALB_post) (adjusted OR: 0.92, 95% CI: 0.85-1.00, P = 0.042) as independent protective factors for MPR, while post-treatment platelet count (PLT_post) was an independent risk factor (adjusted OR: 1.01, 95% CI: 1.00-1.01, P = 0.014). These associations were absent in a chemotherapy-alone control cohort (n=147). ROC analysis determined the optimal pre-treatment neutrophil cutoff at 3.39×10 Conclusion: Pre-treatment neutrophil count, post-treatment platelet count, and post-treatment albumin level are independent predictors of pathologic response to NICT in LAGC. Patients with low pre-treatment neutrophil levels may benefit from extended (4-cycle) neoadjuvant immunochemotherapy with higher pathologic response rates.
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