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Introduction: In patients with cancer, sarcopenia is an indicator of poor prognosis and is associated with an increased risk of chemotherapy-related adverse events. Skeletal muscle interacts with the immune system, and sarcopenia is associated with immune senescence. However, the association between sarcopenia and the response to immune checkpoint inhibitor (ICI) therapy remains unclear., Methods: This retrospective study included patients with advanced or recurrent non-small cell lung cancer treated with nivolumab or pembrolizumab monotherapy. The association between the psoas muscle index (PMI) and both clinical response and immune-related adverse events (irAEs) was assessed using logistic regression. The PMI was calculated as the cross-sectional area of the psoas muscle divided by the square of the height based on computed tomography scans performed before the initial administration of ICI therapy., Results: A total of 67 patients were included in the analysis. Logistic regression analysis showed that PMI was associated with the overall response (odds ratio [OR]: 1.52; 95% confidence interval [CI]: 1.04-2.22; p = 0.030) and the risk of severe irAEs (OR: 1.72; 95% CI: 1.05-2.80; p = 0.031)., Conclusion: These findings suggest that PMI is both an indicator of prognosis and a surrogate marker of immunocompetence in predicting the clinical response to ICI therapy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Tsurui, Hamada, Mura, Suzuki, Iriguchi, Ishiguro, Hirasawa, Ohkuma, Shimokawa, Ariizumi, Kubota, Horiike, Wada, Yoshimura, Tsuji, Kiuchi and Tsunoda.)

Introduction: Immune checkpoint inhibitors (ICIs) have emerged as a promising treatment option for esophageal cancer (EC). Although ICIs enable long-term survival in some patients, the efficacy of ICIs varies widely among patients. Therefore, predictive biomarkers are necessary for identifying patients who are most likely to benefit from ICIs to improve the efficacy of the treatment. We retrospectively analyzed the outcomes of combination therapy, including nivolumab plus ipilimumab or chemotherapy plus anti-programmed cell death 1 (PD-1) antibodies in our institute to identify biomarkers., Methods: Twenty-seven patients received nivolumab plus ipilimumab, and thirty-six patients received chemotherapy plus anti-PD-1 antibodies were included in this study. We analyzed patient characteristics, efficacy, and safety. Multivariable analysis of biomarkers evaluated the correlation among overall survival (OS), progression-free survival (PFS), and the following variables: body mass index, performance status, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein level, and albumin level before treatment., Results: In multivariable analysis, albumin level was significantly correlated with PFS in the cisplatin plus 5-fluorouracil (CF) plus pembrolizumab group. NLR and albumin level were significantly correlated with OS in the nivolumab plus ipilimumab group. Other variables, including PS, BMI, and CRP did not correlate with any of the outcomes., Conclusions: High NLR in EC patients prior to treatment was significantly less effective for ICIs. In chemotherapy combined with ICIs, NLR before the treatment was not associated with treatment efficacy, suggesting combination chemotherapy may be beneficial for EC patients with high NLR. NLR may be an indicator of immunocompetence in anti-tumor immunity and a convenient predictive biomarker for selecting appropriate treatments including ICIs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hirasawa, Kubota, Mura, Suzuki, Tsurui, Iriguchi, Ishiguro, Ohkuma, Shimokawa, Ariizumi, Horiike, Wada, Yamashita, Ariyoshi, Goto, Otsuka, Murakami, Kiuchi, Yoshimura and Tsunoda.)

Background: Cancer of unknown primary (CUP) is a malignant tumor without a known primary lesion with a frequency of 3-5%. It can be divided into favorable and unfavorable prognosis subsets. While recommended treatments are available for the former group, there is no established treatment for the latter. Here, we report the effective treatment of a 32-year-old woman with p16-positive squamous cell CUP with pembrolizumab plus 5-fluorouracil and cisplatin therapy., Case Presentation: A 32-year-old woman presented with metastatic lesions in the liver, lung, bone, cervical region, abdominal region, and pelvic lymph nodes. She was diagnosed with p16-positive squamous cell carcinoma of unknown primary origin. The patient received pembrolizumab plus 5-fluorouracil and cisplatin therapy, which markedly reduced the metastasis and improved her Eastern Cooperative Oncology Group performance status after two courses., Conclusion: This case report highlights the potential of pembrolizumab plus 5-fluorouracil and cisplatin therapy for treating CUP with an unfavorable prognosis. p16 positivity is worth examining for squamous cell carcinoma of unknown primary origin, and if present, this therapy should be considered a promising treatment option., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Suzuki, Hamada, Ohkuma, Homma, Tsurui, Iriguchi, Ishiguro, Hirasawa, Ariizumi, Kubota, Horiike, Yoshimura, Wada, Yamochi and Tsunoda.)