ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2025
Predictive value of EBV-positivity in patients with gastric cancer treated with first-line nivolumab plus chemotherapy.
Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The efficacy and safety of pembrolizumab in the treatment of HER2-negative advanced gastric or gastroesophageal junction cancer: a systematic review and meta-analysis of emerging clinical data.Frontiers in immunology · 2026Pooled it
- Review
- Article
- Article
- Immune checkpoint inhibition inFrontiers in oncology · 2026Article
- Virus-driven remodeling of the immune microenvironment and response to immune checkpoint inhibitors: the infection- immunity-cancer crosstalk.Frontiers in immunology · 2026Review
- Metabolic reprogramming networks in the gastric cancer tumor microenvironment: an integrated axis of nutrient competition, metabolic crosstalk, and immunosuppression.Frontiers in immunology · 2026Review
- The research progress of the synergistic effect of Epstein-Barr virus andFrontiers in oncology · 2026Review
- The immune microenvironment of pathogen-associated cancers and current clinical therapeutics.Molecular cancer · 2025Review
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Abstract
backgroundEpstein-Barr virus (EBV) positivity is a potential predictive biomarker for immune checkpoint inhibitors (ICIs) in gastric cancer patients, but its value in first-line ICI-based chemotherapy remains unclear. This study aimed to evaluate the predictive value of EBV positivity in patients treated with first-line nivolumab plus chemotherapy.
methodsThis single-center study included advanced gastric cancer patients treated with first-line nivolumab plus chemotherapy (n = 293). Patients with EBV positivity treated with chemotherapy alone (n = 12) served as the control group. EBV positivity was confirmed by in situ hybridization.
resultsAmong patients treated with nivolumab plus chemotherapy, 18 (6.1%) had EBV-positive tumors, and these were associated with high PD-L1 combined positive score (CPS) expression levels. Progression-free survival (PFS) and overall survival (OS) tended to be more favorable in those with EBV-positive tumors. Multivariate analysis of patients treated with nivolumab-chemotherapy revealed that EBV positivity, combined with PD-L1 CPS ≥ 5, was an independent factor for PFS. In patients with EBV-positive tumors, nivolumab-chemotherapy was associated with significantly favorable PFS and OS compared to chemotherapy alone. Similar results were observed in the subgroup with PD-L1 CPS ≥ 5. However, survival outcomes did not differ between patients treated with nivolumab plus chemotherapy versus chemotherapy alone in the subgroup with PD-L1 CPS < 5.
conclusionEBV positivity predicts favorable survival outcomes in patients with gastric cancer treated with nivolumab plus chemotherapy. The benefit of nivolumab plus chemotherapy over chemotherapy alone for patients with EBV positivity appears to be associated with high PD-L1 expression levels.
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