Analysis of risk factors and prognostic prediction in advanced colorectal cancer undergoing immunotherapy combined with targeted therapy

作者：Yuan Yuan, Ya‐Fang Chen, Xiaomei Liu, Ying Hu, Shuang Hao, Xin-Yan Dai · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1640469 · 被引用次数：2 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Genetic factors in colorectal cancer、Cancer Immunotherapy and Biomarkers

Background The prognostic implications of systemic inflammatory markers in mismatch repair-proficient (pMMR) advanced colorectal cancer (CRC) treated with immunotherapy combined with targeted therapy remain unclear. This study aimed to identify key clinical and inflammatory markers predictive of overall survival (OS) and progression-free survival (PFS), and to construct a nomogram for individualized outcome prediction. Methods This retrospective study included 216 pMMR advanced CRC patients treated with camrelizumab plus bevacizumab between January 2020 and December 2022. Baseline clinical variables and inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), cancer-inflammation prognostic index (CIPI), and systemic immune-inflammation index (SII), were analyzed. Patients were randomly assigned to a training set ( n = 139) or a validation set ( n = 77). Independent prognostic factors for OS and PFS were identified via multivariable Cox regression. A nomogram was constructed and internally validated using bootstrap resampling (1,000 iterations). Results Elevated body mass index (≥25 kg/m 2 ) was independently associated with improved OS (hazard ratio [HR] = 0.430; 95% CI: 0.185–0.980; p = 0.047), while elevated CIPI (>828.8) and carcinoembryonic antigen (>5 ng/mL) were associated with poorer OS (HR = 1.810, p = 0.045; HR = 2.440, p = 0.025, respectively). For PFS, SII ≥ 663.9 predicted worse outcomes (HR = 2.720; 95% CI: 1.200–6.200; p = 0.016). The ...