Cancer Manag Res. 2026 Jun 24;18:611346. doi: 10.2147/CMAR.S611346. eCollection 2026.
ABSTRACT
BACKGROUND: Nutritional status is a recognized prognostic factor in oncology. However, its impact on patients with recurrent or metastatic nasopharyngeal carcinoma (R/M NPC) treated with the PD-L1 inhibitor KL-A167 remains unclear.
METHODS: We conducted a secondary exploratory analysis of the KL-A167 trial, which included 153 patients with R/M NPC who had progressed after at least two lines of chemotherapy. Baseline nutritional status was assessed using the Controlling Nutritional Status (CONUT) score, Nutritional Risk Index (NRI), and Prognostic Nutritional Index (PNI). The associations between these indices and survival outcomes, including overall survival (OS) and progression-free survival (PFS), were analyzed using Kaplan-Meier methods and Cox regression models.
RESULTS: Baseline nutritional status was associated with survival outcomes. In multivariable Cox analyses as continuous variables, higher CONUT, lower NRI, and lower PNI were all independently associated with worse OS (all p < 0.01), while higher CONUT and lower PNI were independently associated with worse PFS (both p < 0.01). In categorical analyses, high CONUT and low PNI were independently associated with worse OS, and high CONUT, low NRI, and low PNI were independently associated with worse PFS.
CONCLUSION: Baseline nutritional indices, particularly PNI, were associated with OS and PFS in patients with R/M NPC treated with the PD-L1 inhibitor KL-A167. Routine baseline nutritional screening may help identify high-risk patients before immunotherapy, although the clinical benefits of early nutritional interventions remain to be confirmed.
PMID:42371598 | PMC:PMC13310493 | DOI:10.2147/CMAR.S611346
