{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:13:20Z","timestamp":1793722400334,"version":"4.6.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2020R1D1A1B03031275"],"award-info":[{"award-number":["NRF-2020R1D1A1B03031275"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We explored the combined effects of sarcopenia (SAR) and radiotherapy (RT) on outcomes in patients with advanced gastric cancer (AGC) treated with immune-checkpoint blockade (ICB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 185 patients with AGC treated with ICB, we defined SAR as skeletal muscle index &amp;lt;49 cm2\/m2 for men and &amp;lt;31 cm2\/m2 for women; 93 patients met criteria. We defined high neutrophil-to-lymphocyte ratio (hNLR) as NLR\u22653. Palliative RT was performed in 37 patients (20%) before ICB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We frequently observed hNLR in patients with SAR (53%\n                      <jats:italic>vs.<\/jats:italic>\n                      35%, p = 0.02). The median overall survival (OS) for the entire cohort was 5 months. Stratification by risk factors of SAR or hNLR revealed a significant difference in median OS (0 [N = 60]\n                      <jats:italic>vs.<\/jats:italic>\n                      1 [N = 76]\n                      <jats:italic>vs.<\/jats:italic>\n                      2 [N = 49]: 7.6\n                      <jats:italic>vs.<\/jats:italic>\n                      6.4\n                      <jats:italic>vs.<\/jats:italic>\n                      2.2 months, p &amp;lt; 0.001). Patients with microsatellite instability-high (MSI-H, N = 19) or Epstein-Barr virus (EBV)-positive tumors (N = 13) showed favorable outcomes compared to those with microsatellite stable (MSS, N = 142) tumors (median OS, not reached\n                      <jats:italic>vs.<\/jats:italic>\n                      16.8\n                      <jats:italic>vs.<\/jats:italic>\n                      3.8 months, respectively). The benefit of RT was evident in patients with both SAR and hNLR (median OS, 3.1\n                      <jats:italic>vs.<\/jats:italic>\n                      1.3 months, p = 0.02) and MSS\/EBV-negative tumor (median OS, 6.5\n                      <jats:italic>vs.<\/jats:italic>\n                      3.5 months, p = 0.03), but outcomes after RT in MSI-H tumor were not significantly different. In multivariable analysis, SAR\/hNLR, molecular subtypes, and a history of RT were associated with OS (all p &amp;lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We demonstrated the negative predictive value of SAR\/hNLR on outcomes after ICB for AGC, and the history of RT could overcome the negative impact of SAR\/hNLR and the MSS\/EBV-negative subtype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2021.701668","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T04:06:55Z","timestamp":1625717215000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":26,"title":["Prognostic Impact of Sarcopenia and Radiotherapy in Patients With Advanced Gastric Cancer Treated With Anti-PD-1 Antibody"],"prefix":"10.3389","volume":"12","author":[{"given":"Nalee","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Il","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Hoon","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeeyun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Tae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Yong","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Ki","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo Kyoung","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung-Mee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(17)31827-5","article-title":"Nivolumab in Patients With Advanced Gastric or Gastro-Oesophageal Junction Cancer Refractory to, or Intolerant of, at Least Two Previous Chemotherapy Regimens (ONO-4538-12, ATTRACTION-2): A Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial","volume":"390","author":"Kang","year":"2017","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(18)31257-1","article-title":"Pembrolizumab Versus Paclitaxel for Previously Treated, Advanced Gastric or Gastro-Oesophageal Junction Cancer (KEYNOTE-061): A Randomised, Open-Label, 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