The CALLY Index for Unresectable or Recurrent Gastric Cancer Treated With Nivolumab: A Multicenter Retrospective Study.

Authors

Kenji Takeshita, Muneharu Fujisaki, Motohiro Shionozaki, Kazuhide Sato, Mizuki Fukuda, Naoko Fukushima, Yoshitaka Ishikawa, Yuta Takano, Fumiaki Yano, Ken Eto

Published in

Journal of gastric cancer. Volume 26. Issue 4. Pages 598-612.

Abstract

The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel immuno-nutritional marker in various cancers. We investigated its prognostic value in patients with unresectable or recurrent gastric cancer who were treated with nivolumab monotherapy.
This multicenter retrospective study included 126 patients treated with third- or later-line nivolumab monotherapy. The CALLY index was calculated as (Albumin × Lymphocyte Count)/(C-Reactive Protein × 10⁴) and dichotomized at 1.08. The operating characteristics of this cutoff were evaluated using receiver operating characteristic analysis for 1-year overall survival (OS). OS and progression-free survival (PFS) were evaluated.
The CALLY-low group exhibited a significantly shorter median OS (164 vs. 377 days; P=0.004) and median PFS (56 vs. 104 days; P<0.001) than the CALLY-high group. In multivariable models from which posttreatment immune-related adverse events were excluded, the CALLY index was an independent prognostic factor for both OS (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.31-3.21; P=0.002) and PFS (HR, 2.00; 95% CI, 1.33-3.02; P<0.001) after adjustment for clinically relevant factors.
The pretreatment CALLY index was an independent prognostic biomarker for both OS and PFS in patients with unresectable or recurrent gastric cancer receiving third- or later-line nivolumab monotherapy. By integrating the C-reactive protein levels, albumin levels, and lymphocyte counts, the CALLY index may serve as a practical tool for pretreatment risk stratification in this setting.

PMID:
42845259
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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