{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:24:16Z","timestamp":1789683856717,"version":"4.0.1"},"reference-count":36,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Gemcitabine\u2013cisplatin (GC) combined with a programmed death-ligand 1 (PD-L1) inhibitor has become an important first-line regimen for advanced intrahepatic cholangiocarcinoma (ICC). However, overall efficacy remains modest, and inter-patient heterogeneity in outcomes is substantial, highlighting the need for simple biomarkers for pretreatment risk stratification. The systemic immune-inflammation index (SII), derived from peripheral neutrophil, lymphocyte, and platelet counts, has been associated with prognosis in various malignancies, but its clinical relevance in advanced ICC treated with first-line GC plus PD-L1 inhibitor remains unclear. Aims: To evaluate the association of baseline SII with objective response and survival outcomes in patients with advanced ICC receiving first-line GC plus PD-L1 inhibitor. Methods: We retrospectively analyzed 193 consecutive patients with advanced ICC who received first-line GC plus a PD-L1 inhibitor at our center. Baseline clinicopathologic characteristics and laboratory parameters were collected, and SII was calculated as platelet count (\u00d7109\/L) \u00d7 neutrophil count (\u00d7109\/L)\/lymphocyte count (\u00d7109\/L). Receiver operating characteristic (ROC) analysis was performed to assess the discriminative ability of baseline SII for objective response and to determine an internally derived cut-off value. Patients were categorized into low- and high-SII groups accordingly. Logistic regression was used to identify factors associated with objective response rate (ORR). Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan\u2013Meier method and compared using the log-rank test. Multivariable Cox proportional hazards models were constructed to evaluate the independent prognostic significance of SII for PFS and OS. Results: Among the 193 patients included, 55 achieved complete or partial response and 138 had stable or progressive disease, yielding an ORR of 28.5%. Baseline SII showed good discrimination for objective response (AUC = 0.91), and the optimal cut-off value was 495.75. Patients in the low-SII group had a significantly higher ORR than those in the high-SII group (p &lt; 0.001). Kaplan\u2013Meier analysis demonstrated that both PFS and OS were longer in the low-SII group than in the high-SII group (median OS: 13.0 vs. 8.0 months, log-rank p &lt; 0.001; median PFS: 8.5 vs. 6.0 months, p = 0.025). In multivariable Cox models adjusting for differentiation, CA19-9, tumor multiplicity, and distant metastasis, SII grouping remained independently associated with PFS and OS, and distant metastasis was consistently associated with increased risks of progression and death. Conclusions: Baseline SII is a readily available prognostic biomarker associated with objective response and survival in patients with advanced ICC treated with first-line GC plus PD-L1 inhibitor. Given the retrospective single-center design, the absence of a non-immunotherapy comparator cohort, and internal cut-off derivation, these findings should be interpreted as hypothesis-generating and warrant external validation.<\/jats:p>","DOI":"10.3390\/curroncol33020123","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T09:55:31Z","timestamp":1771494931000},"page":"123","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Value of Baseline Systemic Immune-Inflammation Index in Advanced Intrahepatic Cholangiocarcinoma Treated with First-Line Gemcitabine\u2013Cisplatin Plus PD-L1 Inhibitor: A Single-Center Retrospective Study"],"prefix":"10.3390","volume":"33","author":[{"given":"Shuan","family":"Wu","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Decai","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1038\/s41575-020-0310-z","article-title":"Cholangiocarcinoma 2020: The next horizon in mechanisms and management","volume":"17","author":"Banales","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2023). EASL-ILCA Clinical Practice Guidelines on the management of intrahepatic cholangiocarcinoma. J. Hepatol., 79, 181\u2013208.","DOI":"10.1016\/j.jhep.2023.09.006"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.annonc.2022.10.506","article-title":"Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"34","author":"Vogel","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_4","first-page":"198","article-title":"Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians","volume":"73","author":"Moris","year":"2022","journal-title":"CA Cancer J. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1056\/NEJMoa0908721","article-title":"Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer","volume":"362","author":"Valle","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_6","first-page":"200","article-title":"Advanced Intrahepatic Cholangiocarcinoma: Post Hoc Analysis of the ABC-01, -02, and -03 Clinical Trials","volume":"112","author":"Lamarca","year":"2020","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/S2468-1253(24)00095-5","article-title":"Durvalumab or placebo plus gemcitabine and cisplatin in participants with advanced biliary tract cancer (TOPAZ-1): Updated overall survival from a randomised phase 3 study","volume":"9","author":"Oh","year":"2024","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/j.jhep.2025.05.003","article-title":"Durvalumab plus chemotherapy in advanced biliary tract cancer: 3-year overall survival update from the phase III TOPAZ-1 study","volume":"83","author":"Oh","year":"2025","journal-title":"J. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1002\/cac2.70036","article-title":"Simvastatin overcomes the pPCK1-pLDHA-SPRINGlac axis-mediated ferroptosis and chemo-immunotherapy resistance in AKT-hyperactivated intrahepatic cholangiocarcinoma","volume":"45","author":"Zhu","year":"2025","journal-title":"Cancer Commun."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"215853","DOI":"10.1016\/j.canlet.2022.215853","article-title":"Immunotherapy of cholangiocarcinoma: Therapeutic strategies and predictive biomarkers","volume":"546","author":"Chen","year":"2022","journal-title":"Cancer Lett."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Shang, T., Jiang, T., Lu, T., Wang, H., Cui, X., Pan, Y., Xu, M., Pei, M., Ding, Z., and Feng, X. (2023). Tertiary lymphoid structures predict the prognosis and immunotherapy response of cholangiocarcinoma. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1166497"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6212","DOI":"10.1158\/1078-0432.CCR-14-0442","article-title":"Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma","volume":"20","author":"Hu","year":"2014","journal-title":"Clin. Cancer Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"75381","DOI":"10.18632\/oncotarget.18856","article-title":"Prognostic role of systemic immune-inflammation index in solid tumors: A systematic review and meta-analysis","volume":"8","author":"Zhong","year":"2017","journal-title":"Oncotarget"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e18571","DOI":"10.1097\/MD.0000000000018571","article-title":"Prognostic impact of elevated pre-treatment systemic immune-inflammation index (SII) in hepatocellular carcinoma: A meta-analysis","volume":"99","author":"Wang","year":"2020","journal-title":"Medicine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1007\/s10238-022-00889-y","article-title":"Systemic immune-inflammation index and the survival of hepatocellular carcinoma patients after transarterial chemoembolization: A meta-analysis","volume":"23","author":"Li","year":"2022","journal-title":"Clin. Exp. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40364-024-00722-6","article-title":"The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy","volume":"13","author":"He","year":"2025","journal-title":"Biomark. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Hong, Y.M., Yoon, K.T., and Cho, M. (2021). Systemic immune-inflammation index predicts prognosis of sequential therapy with sorafenib and regorafenib in hepatocellular carcinoma. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08124-9"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zhu, J., Wang, D., Liu, C., Huang, R., Gao, F., Feng, X., Lan, T., Li, H., and Wu, H. (2023). Development and validation of a new prognostic immune-inflammatory-nutritional score for predicting outcomes after curative resection for intrahepatic cholangiocarcinoma: A multicenter study. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1165510"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6656996","DOI":"10.1155\/2021\/6656996","article-title":"Systemic Immune-Inflammation Index Is a Prognostic Predictor in Patients with Intrahepatic Cholangiocarcinoma Undergoing Liver Transplantation","volume":"2021","author":"Ren","year":"2021","journal-title":"Mediators Inflamm."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Yin, X., Yin, Y., Li, W., Tong, J., Liu, Y., Chang, J., Ma, J., Xie, Y., Li, X., and Mehrabanidil, H. (2025). Systemic immune-inflammation index: A key biomarker guiding personalized adjuvant chemotherapy in intrahepatic cholangiocarcinoma. Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1702336"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"541","DOI":"10.2147\/ITT.S471502","article-title":"Assessing the Prognostic Value of 13 Inflammation-Based Scores in Patients with Unresectable or Advanced Biliary Tract Carcinoma After Immunotherapy","volume":"13","author":"Wang","year":"2024","journal-title":"Immunotargets Ther."},{"key":"ref_22","first-page":"377","article-title":"Evaluating the prognostic impact of inflammatory markers on treatment outcomes in patients with intrahepatic cholangiocarcinoma undergoing radioembolization","volume":"31","author":"Dik","year":"2024","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_24","first-page":"11","article-title":"Tumor microenvironment and immunology of cholangiocarcinoma","volume":"8","author":"Cadamuro","year":"2022","journal-title":"Hepatoma Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ricci, A.D., Rizzo, A., Schirizzi, A., D\u2019Alessandro, R., Frega, G., Brandi, G., Shahini, E., Cozzolongo, R., Lotesoriere, C., and Giannelli, G. (2024). Tumor Immune Microenvironment in Intrahepatic Cholangiocarcinoma: Regulatory Mechanisms, Functions, and Therapeutic Implications. Cancers, 16.","DOI":"10.3390\/cancers16203542"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.jhep.2023.05.010","article-title":"Immunobiology of cholangiocarcinoma","volume":"79","author":"Tomlinson","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"467","DOI":"10.4251\/wjgo.v12.i4.467","article-title":"Prognostic significance of systemic immune-inflammation index in patients with intrahepatic cholangiocarcinoma undergoing hepatic resection","volume":"12","author":"Li","year":"2020","journal-title":"World J. Gastrointest. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s12029-021-00596-z","article-title":"Prognostic Role of a New Index Tested in European and Korean Advanced Biliary Tract Cancer Patients: The PECS Index","volume":"53","author":"Rovesti","year":"2021","journal-title":"J. Gastrointest. Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Liu, X.-C., Jiang, Y.-P., Sun, X.-G., Zhao, J.-J., Zhang, L.-Y., and Jing, X. (2022). Prognostic Significance of the Systemic Immune-Inflammation Index in Patients with Cholangiocarcinoma: A Meta-Analysis. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.938549"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e2400216","DOI":"10.1200\/GO.24.00216","article-title":"Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India","volume":"10","author":"Muddu","year":"2024","journal-title":"JCO Glob. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2302","DOI":"10.21037\/jgo-2025-336","article-title":"Construction of a predictive model for gemcitabine combined with cisplatin resistance in intrahepatic cholangiocarcinoma based on multidimensional inflammatory indices","volume":"16","author":"Zhou","year":"2025","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Fan, R., Chen, Y., Xu, G., Pan, W., Lv, Y., and Zhang, Z. (2023). Combined systemic immune-inflammatory index and prognostic nutritional index predict outcomes in advanced non-small cell lung cancer patients receiving platinum-doublet chemotherapy. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.996312"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Ding Pa Guo, H., Sun, C., Yang, P., Kim, N.H., Tian, Y., Liu, Y., Liu, P., Li, Y., and Zhao, Q. (2022). Combined systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) predicts chemotherapy response and prognosis in locally advanced gastric cancer patients receiving neoadjuvant chemotherapy with PD-1 antibody sintilimab and XELOX: A prospective study. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02199-9"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e007054","DOI":"10.1136\/jitc-2023-007054","article-title":"Associations of subcutaneous fat area and Systemic Immune-inflammation Index with survival in patients with advanced gastric cancer receiving dual PD-1 and HER2 blockade","volume":"11","author":"He","year":"2023","journal-title":"J. Immunother. Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Ni, J., Qi, X., Jin, C., Xu, W., Li, X., Song, L., and Zhang, X. (2025). Efficacy prediction of systemic immune-inflammation index and prognostic nutritional index in breast cancer patients and their variations after neoadjuvant chemotherapy. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1514736"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1080\/14728222.2021.1882998","article-title":"Targeting the tumor microenvironment in cholangiocarcinoma: Implications for therapy","volume":"25","author":"Louis","year":"2021","journal-title":"Expert. Opin. Ther. Targets"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/123\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T10:06:18Z","timestamp":1771495578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["curroncol33020123"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33020123","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]}}}