Comparison of the effectiveness of chemotherapy combined with immunotherapy and chemotherapy alone in advanced biliary tract cancer and construction of the nomogram for survival prediction based on the inflammatory index and controlling nutritional status score

• DOI: 10.1007/s00262-023-03513-4
• Publication Date: 2023-09-05T12:02:27Z
• Authors: Zhengfeng Zhang; Dazhen Wang; Jianji Zhang; Yuli Ruan; Lu Zhao; Liu Yang; Ze Liu; Lei Yang; Changjie Lou
• Keywords: Nomogram; Univariate analysis; Biliary Tract Cancer

To analyze the effectiveness of combining immune checkpoint inhibitors (ICIs) with first-line therapy in patients advanced biliary tract cancer (BTC) and explore biomarkers affecting prognosis immunotherapy, to construct a nomogram for prediction survival.A retrospective study was conducted include total 209 BTC treated first line from 2018 2022, divided into combination group (n = 129) chemotherapy-only 80) according whether ICIs were applied combination. Univariate multifactorial COX regression analyses performed on variables that may affect identify independent influences patient prognosis, this used create nomograms, which then prospectively validated calibrated.The median progression-free survival (mPFS) overall (mOS) higher than those chemotherapy alone [hazard ratio (HR) 1.152, 95% confidence interval (CI): 0.7848-1.692, p 0.0004, HR 1.067, CI: 0.7474-1.524, 0.0016]. The objective response rate (ORR) groups 39.5% (51/129) vs. 27.5% (22/80), disease control (DCR) between two 89.9% (116/129) 83.8% (67/80). analysis revealed gender, presence long-term tobacco alcohol, degree histological differentiation, serum albumin level, liver metastases, multi-visceral response, neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), monocyte-to-lymphocyte (MLR), glycoprotein antigen 19-9 (CA19-9), systemic inflammatory index (SII), controlling nutritional status (CONUT) scores statistically significant (all P values < 0.05). Multi-factor continued above variables, results showed NLR, MLR, PLR, SII, CONUT patients' OS A (C-index 0.77, 0.71-0.84) created based these later using validation cohort 0.75, 0.68-0.81). time-dependent receiver operator characteristic curve (ROC) area under (AUC) training at 12, 18, 24 months 0.72 (95% 0.63-0.81), 0.75 0.67-0.85), 0.77 0.66-0.87) AUC 0.69 0.58-0.79), 0.74 0.65-0.87), 0.71 0.64-0.89), respectively. Finally, calibration curves, nomograms metrics could be assess (12, months) line.Patients benefit more treatment standard alone. In addition, can predict ICIs.