{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T03:29:12Z","timestamp":1786418952054,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The CheckMate 649 trial showed the superiority of first\u2010line nivolumab plus chemotherapy (Nivo\u2010CT) over chemotherapy alone for advanced gastric or gastroesophageal junction (GEJ) cancer with a programmed cell death\u2010ligand 1 (PD\u2010L1) combined positive score (CPS)\u2009\u2265\u20095. However, few studies have investigated the correlation between PD\u2010L1 CPS and the efficacy of first\u2010line Nivo\u2010CT in the real\u2010world setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study included patients with unresectable advanced or recurrent gastric or GEJ cancer who were started on first\u2010line Nivo\u2010CT between December 2021 and December 2023 at any of four institutions in Japan. PD\u2010L1 CPS was classified into three groups (&lt;\u20091, 1 to &lt;\u20095, and \u2265\u20095) before the start of Nivo\u2010CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 234 patients were included (median age 70\u2009years; 64.5% male; 89.7% with gastric primary). PD\u2010L1 CPS was &lt;\u20091 in 35 patients (15.0%), 1 to &lt;\u20095 in 76 (32.5%), and \u2265\u20095 in 123 (52.5%). Median follow\u2010up was 14.0\u2009months (range 2.3\u201330.3). Median overall survival was 18.7 (95% confidence interval [CI] 17.4\u2013not reached), 23.4 (95% CI 17.7\u2013not reached), and 18.3\u2009months (95% CI 13.3\u201322.5), with objective response rates of 30.8%, 66.7%, and 61.3%. Multivariate analysis did not identify PD\u2010L1 CPS as a prognostic factor, whereas an Eastern Cooperative Oncology Group performance status \u2265\u20091, a GEJ primary, and two or more metastatic sites were associated with poor prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PD\u2010L1 CPS had no significant effect on prognosis in patients with unresectable advanced or recurrent gastric or GEJ cancer treated with first\u2010line Nivo\u2010CT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72095","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:41:13Z","timestamp":1783327273000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of the\n                    <scp>PD<\/scp>\n                    \u2010\n                    <scp>L1 CPS<\/scp>\n                    With the Efficacy of First\u2010Line Nivolumab Plus Chemotherapy for Unresectable Advanced or Recurrent Gastric Cancer"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1803-2895","authenticated-orcid":false,"given":"Nozomu","family":"Ogura","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3504-1105","authenticated-orcid":false,"given":"Misa","family":"Ohnishi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kanagawa Cancer Center  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5696-518X","authenticated-orcid":false,"given":"Rin","family":"Inamoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Cancer Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3677-9880","authenticated-orcid":false,"given":"Yosuke","family":"Kito","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Ishikawa Prefectural Central Hospital  Ishikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4529-9045","authenticated-orcid":false,"given":"Kengo","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Clinical and Translational Research Center Keio University Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6377-9507","authenticated-orcid":false,"given":"Naoki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Cancer Center  Saitama 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