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Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma

  • Authors:
    • Nobufumi Sekino
    • Takeshi Toyozumi
    • Kentaro Murakami
    • Masaya Uesato
    • Akira Nakano
    • Tadashi Shiraishi
    • Koichi Hayano
    • Yasunori Matsumoto
    • Yoshihiro Kurata
    • Ryota Otsuka
    • Sho Hirano
    • Hideki Hayashi
    • Hisahiro Matsubara
  • View Affiliations / Copyright

    Affiliations: Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba 260‑8670, Japan
    Copyright: © Sekino et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 90
    |
    Published online on: August 7, 2025
       https://doi.org/10.3892/mco.2025.2885
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Abstract

Esophageal squamous cell carcinoma (ESCC) is refractory to multidisciplinary treatment. Immunotherapy targeting programmed cell death protein 1 has shown promise in recent years; however, predicting its therapeutic efficacy remains difficult. The present study aimed to identify the factors associated with treatment response in patients receiving nivolumab after radical chemoradiotherapy for ESCC and to predict treatment efficacy based on these factors. A total of 22 patients were classified into partial response (PR) + stable disease (SD) and progressive disease (PD) groups based on their response to nivolumab. Factors associated with the treatment response were analyzed, including clinical stage, patient background and pre‑treatment blood test results. Among the 22 patients, nine and 13 were classified into the PR + SD and PD groups, respectively. Notably, treatment efficacy had a significant impact on prognosis. Variables such as height, weight, body mass index, white blood cell count, basophil fraction, platelet count, albumin, creatinine and C‑reactive protein were also evaluated. Cut‑off values were determined using the Youden index for body weight (53.5 kg), white blood cells (5,000/mm3), basophils (0.6%), platelets (145x104/mm3), albumin (3.9 m g/dl) and C‑reactive protein (0.10 mg/dl). The number of favorable variables was calculated for each patient based on these cut‑off values. Nine patients in the PR + SD group had three or more favorable variables, whereas 13 patients in the PD group had two or fewer. In conclusion, although the current study had a limited sample size, the six identified variables appear promising for predicting the efficacy of immune checkpoint inhibitors.
View Figures

Figure 1

Association between nivolumab
administration following CRT and OS. (A) OS of patients with or
without nivolumab administration following CRT did not show a
significant difference (P=0.1333). (B) A large difference was
observed in OS classified by the first treatment effect of
nivolumab (P=0.0004). (C) OS classified by the presence/absence of
nivolumab treatment and first treatment effect was superior in the
PR + SD group (P=0.0126). CRT, chemoradiotherapy; OS, overall
survival; PR, partial response; SD, stable disease; PD, progressive
disease.

Figure 2

Association between categorical
variables and OS. (A) Patients with body weight ≥53.5 kg had
significantly better OS than those with body weight <53.5 kg
(P=0.0001). (B) Patients with WBC ≤5,000 had significantly better
OS than those with WBC >5,000 (P=0.0136). (C) Patients with
basophil (%) ≥0.6 had significantly better OS than those with
basophil (%) <0.6 (P=0.0004). (D) Patients with platelet <145
had better OS than those with relative platelet ≥145 (P=0.1227).
(E) Patients with albumin ≥3.9 had better OS than those with
relative albumin <3.9 (P=0.0777). (F) Patients with CRP ≤0.10
had significantly better OS than those with CRP >0.10
(P=0.0039). OS, overall survival; WBC, white blood cell count; CRP,
C-reactive protein.

Figure 3

Association between total score and
OS. Patients with total score ≥3 had significantly better OS than
those with total score ≤2 (P=0.0001). OS, overall survival.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Sekino N, Toyozumi T, Murakami K, Uesato M, Nakano A, Shiraishi T, Hayano K, Matsumoto Y, Kurata Y, Otsuka R, Otsuka R, et al: Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma. Mol Clin Oncol 23: 90, 2025.
APA
Sekino, N., Toyozumi, T., Murakami, K., Uesato, M., Nakano, A., Shiraishi, T. ... Matsubara, H. (2025). Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma. Molecular and Clinical Oncology, 23, 90. https://doi.org/10.3892/mco.2025.2885
MLA
Sekino, N., Toyozumi, T., Murakami, K., Uesato, M., Nakano, A., Shiraishi, T., Hayano, K., Matsumoto, Y., Kurata, Y., Otsuka, R., Hirano, S., Hayashi, H., Matsubara, H."Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma". Molecular and Clinical Oncology 23.4 (2025): 90.
Chicago
Sekino, N., Toyozumi, T., Murakami, K., Uesato, M., Nakano, A., Shiraishi, T., Hayano, K., Matsumoto, Y., Kurata, Y., Otsuka, R., Hirano, S., Hayashi, H., Matsubara, H."Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma". Molecular and Clinical Oncology 23, no. 4 (2025): 90. https://doi.org/10.3892/mco.2025.2885
Copy and paste a formatted citation
x
Spandidos Publications style
Sekino N, Toyozumi T, Murakami K, Uesato M, Nakano A, Shiraishi T, Hayano K, Matsumoto Y, Kurata Y, Otsuka R, Otsuka R, et al: Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma. Mol Clin Oncol 23: 90, 2025.
APA
Sekino, N., Toyozumi, T., Murakami, K., Uesato, M., Nakano, A., Shiraishi, T. ... Matsubara, H. (2025). Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma. Molecular and Clinical Oncology, 23, 90. https://doi.org/10.3892/mco.2025.2885
MLA
Sekino, N., Toyozumi, T., Murakami, K., Uesato, M., Nakano, A., Shiraishi, T., Hayano, K., Matsumoto, Y., Kurata, Y., Otsuka, R., Hirano, S., Hayashi, H., Matsubara, H."Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma". Molecular and Clinical Oncology 23.4 (2025): 90.
Chicago
Sekino, N., Toyozumi, T., Murakami, K., Uesato, M., Nakano, A., Shiraishi, T., Hayano, K., Matsumoto, Y., Kurata, Y., Otsuka, R., Hirano, S., Hayashi, H., Matsubara, H."Patient background and laboratory variables associated with the efficacy of nivolumab after chemoradiotherapy in esophageal squamous cell carcinoma". Molecular and Clinical Oncology 23, no. 4 (2025): 90. https://doi.org/10.3892/mco.2025.2885
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