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Prognostic value of natural killer cell activity for patients with HER2 + advanced gastric cancer treated with first-line fluoropyrimidine–platinum doublet plus trastuzumab

Cancer Immunology, Immunotherapy volume 71, pages 829–838 (2022)Cite this article

Abstract

Background

We aimed to evaluate the prognostic value of natural killer (NK) cell activity for patients with HER2 + advanced gastric cancer (AGC) treated with first-line fluoropyrimidine–platinum doublet plus trastuzumab.

Methods

Forty-one patients with HER2 + AGC who received fluoropyrimidine–platinum doublet plus trastuzumab as first-line treatment were prospectively enrolled. NK cell activity was evaluated using the NK Vue®.

Results

The median age was 63.5 years, and 31 patients (75.6%) were male. Patients with low baseline NK cell activity (≤ median, n = 21) were associated worse progression-free survival (PFS) and overall survival (OS) compared with patients with high baseline NK cell activity (> median, n = 20) with a median PFS of 4.21 vs. 9.53 months (P < 0.001), and median OS of 8.15 months vs. 17.82 months (P = 0.025), respectively. In the multivariate analysis, low baseline NK cell activity was independently associated with poor PFS (HR 4.35, P = 0.007). NK cell activity recovered to a normal range in nine patients (47.4%) with a low baseline NK cell activity (n = 19) after two cycles of treatment. The median PFS and OS among patients with recovered NK cell activity were significantly better than that among patients with persistently low NK cell activity (PFS, P = 0.038; OS, P = 0.003).

Conclusion

Our results demonstrated the prognostic value of baseline NK cell activity for patients with HER2 + AGC treated with fluoropyrimidine–platinum doublet plus trastuzumab. The association between treatment outcomes and dynamic changes in NK cell activity suggests that NK cell treatment may improve treatment outcomes, especially for patients with low baseline NK cell activity.

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Availability of data and material

Data are available on reasonable request.

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Author notes

  1. Hyungwoo Cho and Min-Hee Ryu equally contributed to this work.

Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Hyungwoo Cho, Min-Hee Ryu, Hyung Eun Lee, Hyung-Don Kim & Yoon-Koo Kang

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Correspondence to Yoon-Koo Kang.

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Hyungwoo Cho and Min-Hee Ryu are Co-first authors.

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Cho, H., Ryu, MH., Lee, H.E. et al. Prognostic value of natural killer cell activity for patients with HER2 + advanced gastric cancer treated with first-line fluoropyrimidine–platinum doublet plus trastuzumab. Cancer Immunol Immunother 71, 829–838 (2022). https://doi.org/10.1007/s00262-021-03035-x

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