Efficacy of timing‑dependent infusion of nivolumab in patients with advanced gastric cancer

Tanaka,Toshimitsu; Suzuki,Hiroyuki; Yamaguchi,Shotaro; Shimotsuura,Yasutaka; Nagasu,Sachiko; Murotani,Kenta; Fujita,Fumihiko; Kawaguchi,Takumi; Miwa,Keisuke

doi:10.3892/ol.2024.14596

Efficacy of timing‑dependent infusion of nivolumab in patients with advanced gastric cancer

Authors:
- Toshimitsu Tanaka
- Hiroyuki Suzuki
- Shotaro Yamaguchi
- Yasutaka Shimotsuura
- Sachiko Nagasu
- Kenta Murotani
- Fumihiko Fujita
- Takumi Kawaguchi
- Keisuke Miwa
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Affiliations: Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Fukuoka 830‑0011, Japan, Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan, Biostatistics Center, Kurume University, Kurume, Fukuoka 830‑0011, Japan, Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
Published online on: July 29, 2024 https://doi.org/10.3892/ol.2024.14596
Article Number: 463
Copyright: © Tanaka et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Although an association exists between the timing of immune checkpoint inhibitor (ICI) administration and therapeutic efficacy in several types of cancer, to the best of our knowledge, no reports exist regarding this relationship in gastric cancer (GC). The present study aimed to evaluate the optimal timing of ICI (nivolumab) administration in patients with advanced GC. A total of 58 consecutive patients with advanced GC who received nivolumab monotherapy after ≥2 chemotherapy regimens were retrospectively evaluated. These patients were divided into two groups according to the median time of nivolumab administration: i) Early‑timing and (ii) late‑timing groups, and the efficacy was assessed in both groups. The early‑timing group had significantly longer overall survival (OS) than the late‑timing group [median OS 8.2 months; 95% confidence interval (CI), 4.2‑12.9 vs. median OS 5.4 months; 95% CI, 3.6‑6.1]. Moreover, patients in the early‑timing group had significantly longer progression‑free survival (PFS) than those in the late‑timing group (median PFS 2.6 months; 95% CI, 1.3‑3.9 months vs. median PFS 1.6 months; 95% CI, 0.9‑2.1 months). Furthermore, univariate analysis showed that early timing, immune‑related adverse events and nonsteroidal anti‑inflammatory drug administration were associated with longer OS and PFS. Cutoff Finder analysis revealed that the optimal timing of nivolumab administration for achieving better outcomes was before 12:06 p.m. Nivolumab administration in the morning, especially before 12:06 p.m., had a better clinical impact on patients with advanced GC.

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