Prognostic Value of Early Weight Gain in Patients With Stage IV Gastric Cancer Undergoing First-Line Combination Immunotherapy.

Authors

Kaihua Huang, Min Lai, Huiming Zhang, Huayuan Liang, Xiao Yan, Qingling Yu, Huilin Huang, Rou Zhong, Qing Xie, Xinru Liu, Zhiwei Li, Lina Yu, Hao Liu, Guoxin Li, Liying Zhao

Published in

Journal of gastric cancer. Volume 26. Issue 4. Pages 552-572.

Abstract

Conventional radiologic assessment using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) may not fully capture clinical responses during immunotherapy. Therefore, we investigated the association between early weight gain (WG) and prognosis in this population.
We enrolled 268 consecutive patients with stage IV gastric cancer (GC) who received first-line combination immunotherapy. Data were obtained from a prospective clinical database. Cox regression and g-computation were used to quantify and visualize the associations between WG and progression-free survival (PFS) and overall survival (OS). The skeletal muscle index (SMI), subcutaneous fat index (SFI), and visceral fat index (VFI) at L3 were calculated using 3D Slicer.
After a median follow-up of 29.7 months, 210 (78.3%) patients experienced disease progression and 185 (69.0%) died. The median overall survival (mOS) was 14.8 months, and the median progression-free survival (mPFS) was 7.2 months. The optimal cutoff value for WG was 4%, classifying patients into the WG ≥4% (n=87) and WG <4% (n=181) groups. WG ≥4% was associated with longer mOS (hazard ratio [HR], 0.225; P<0.001) and mPFS (HR, 0.449; P<0.001). WG ≥4% was also significantly associated with prolonged mOS in patients with stable disease (SD) (HR, 0.140; P<0.001) and progressive disease (PD) (HR, 0.045; P=0.003). Multivariate Cox regression analysis confirmed WG as an independent predictor of survival outcomes. SFI (r=0.34) and SMI (r=0.32) were moderately and positively correlated with OS.
WG ≥4% is associated with better survival outcomes in patients with stage IV GC undergoing combination immunotherapy, even in those with SD or PD.

PMID:
42845256
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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