The Gastric Cancer Immune Prognostic Score (GCIPS) Shows Potential in Predicting an Unfavorable Prognosis for Gastric Cancer Patients Undergoing Immune Checkpoint Inhibitor Treatment

Simple Summary In the current landscape of gastric cancer treatment, identifying patients who can benefit from immunotherapy and determining high-risk individuals post immunotherapy remain pivotal objectives. Numerous studies have confirmed the value of classical inflammatory and nutritional markers in predicting the prognosis of patients undergoing immunotherapy. However, these markers have been in use for a long time, and the treatment strategies for gastric cancer have undergone significant changes. Therefore, proposing a novel biomarker based on the latest treatment strategies is necessary. This study established the Gastric Cancer Immune Prognostic Score (GCIPS) through comprehensive blood parameter analysis before immunotherapy, utilizing Cox regression analysis. Comprising white blood cells, lymphocytes, and the international normalized ratio (INR), the GCIPS not only demonstrated excellent performance in survival analyses across all subgroups but was also identified as an independent prognostic factor in this study. Furthermore, the GCIPS exhibited the highest prognostic value, surpassing even the TNM stage and radical resection. Analysis in the validation set further confirmed the accuracy and stability of the results. The proposal of the GCIPS provides a new reference for developing immunotherapy strategies. Abstract (1) Background: This study aims to explore the predictive capability of the Gastric Cancer Immune Prognostic Score (GCIPS) for an unfavorable prognosis in gastric cancer patients undergoing immune checkpoint inhibitor (ICI) treatment. (2) Methods: This study included 302 gastric cancer patients who underwent treatment with ICIs at our institution from January 2017 to December 2022. The patients were randomly divided into a test set (201 cases) and a validation set (101 cases) using a random number table. Kaplan–Meier survival analysis and the log-rank test were used to investigate survival differences. Cox regression analysis and Lasso regression analysis were employed to establish the GCIPS and identify independent prognostic indicators. ROC curves, time–ROC curves, and nomograms were utilized to further explore the predictive performance of GCIPS. (3) Results: The test set and validation set showed no statistical differences in clinical and pathological features, as well as blood parameters (all p > 0.05). Cox regression analysis revealed that white blood cells (WBC), lymphocytes (LYM), and the international normalized ratio (INR) emerged as independent prognostic blood indicators after eliminating collinearity through Lasso analysis. The GCIPS was established using β coefficients with the following formula: GCIPS = WBC (109/L) × 0.071 − LYM (109/L) × 0.375 + INR × 2.986. ROC curves based on death and time–ROC curves demonstrated that the GCIPS had higher AUCs than other classical markers at most time points. Survival analyses of all subgroups also revealed a significant correlation between the GCIPS and patients’ progression-free survival (PFS) and overall survival (OS) (all p < 0.05). Furthermore, the GCIPS was identified as an independent prognostic factor for both PFS and OS. Analyses in the validation set further confirmed the reliability and stability of the GCIPS in predicting patient prognosis. Finally, nomograms incorporating the GCIPS exhibited high accuracy in both the test and validation sets. Additionally, the nomograms revealed that the GCIPS had a higher prognostic value than any other factor, including the TNM stage. (4) Conclusions: The GCIPS demonstrated its ability to predict adverse outcomes in gastric cancer patients undergoing ICIs treatment and had a high prognostic value. As a readily accessible and simple novel biomarker, it effectively identified high-risk patients.