旨在确定营养状况是否影响妇科恶性肿瘤女性对免疫治疗的反应。对 2015 年至 2022 年间在单一机构接受免疫治疗的妇科癌症患者进行了回顾性图表审查。免疫治疗包括检查点抑制剂和肿瘤疫苗。根据血清白蛋白水平和总淋巴细胞计数计算预后营养指数（PNI）。在每位患者的治疗开始时确定 PNI 值，并评估其与免疫治疗反应的相关性。疾病控制反应（DCR）作为免疫治疗的结果，被定义为完全缓解、部分缓解或疾病稳定。2015年至2022年间，198名患者接受了免疫治疗（IT）。治疗的妇科癌症是子宫癌（38%） ）、子宫颈癌（32%）、卵巢癌（25%）以及外阴或阴道癌（4%）。响应者的平均 PNI 高于无响应者组 (p < 0.05)。作为反应预测因子的 PNI 的 AUC 值为 49。PNI 值为 49 时，预测 DCR 的敏感性为 43%，特异性为 85%。在 Cox 比例风险分析中，调整 ECOG 评分和既往化疗线数后，严重营养不良与无进展生存期 (PFS)（HR = 1.85，p = 0.08）和总生存期 (OS)（HR = 3.82）相关，p < 0.001）。 PNI < 49 的患者发生 IT 失败 (HR = 2.24，p = 0.0001) 和随后死亡 (HR = 2.84，p = 9 × 10-5) 的风险较高。PNI 可以作为预测缓解率的预后标志物接受免疫疗法治疗的妇科癌症患者。需要进行更多研究来了解营养不良在免疫治疗反应中的机制作用。版权所有 © 2024 Elsevier Inc. 保留所有权利。

To determine if nutritional status effects response to immunotherapy in women with gynecologic malignancies.A retrospective chart review was conducted on gynecologic cancer patients who received immunotherapy at a single institution between 2015 and 2022. Immunotherapy included checkpoint inhibitors and tumor vaccines. The prognostic nutritional index (PNI) was calculated from serum albumin levels and total lymphocyte count. PNI values were determined at the beginning of treatment for each patient and assessed for their association with immunotherapy response. Disease control response (DCR) as an outcome of immunotherapy was defined as complete response, partial response, or stable disease.One hundred and ninety-eight patients received immunotherapy (IT) between 2015 and 2022. The gynecological cancers treated were uterine (38%), cervix (32%), ovarian (25%), and vulvar or vaginal (4%) cancers. The mean PNI for responders was higher than the non-responder group (p < 0.05). The AUC value for PNI as a predictor of response was 49. A PNI value of 49 was 43% sensitive and 85% specific for predicting a DCR. In Cox proportional hazards analysis, after adjusting for ECOG score and the number of prior chemotherapy lines, severe malnutrition was associated with progression-free survival (PFS) (HR = 1.85, p = 0.08) and overall survival (OS) (HR = 3.82, p < 0.001). Patients with PNI < 49 were at a higher risk of IT failure (HR = 2.24, p = 0.0001) and subsequent death (HR = 2.84, p = 9 × 10-5).PNI can be a prognostic marker to predict response rates of patients with gynecologic cancers treated with immunotherapy. Additional studies needed to understand the mechanistic role of malnutrition in immunotherapy response.Copyright © 2024 Elsevier Inc. All rights reserved.