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Purpose <p>To investigate the independent predictors of progression-free survival (PFS) after gemcitabine, cisplatin, and durvalumab (GCD) therapy for advanced biliary tract cancer (BTC), including the thyroid-stimulating hormone (TSH) ratio pre- and post-GCD.</p> Methods <p>The subjects of this retrospective analysis were 29 patients receiving GCD for advanced BTC. The cutoff TSH ratios were determined by a receiver operating characteristic (ROC) curve for PFS. The independent predictors of PFS after GCD were determined by univariate and multivariate analyses.</p> Results <p>The median PFS was 4.9 (range, 0.9–16.8) months. The objective response and disease control rates were 13.0% and 52.2%, respectively. The cutoff values of the TSH ratio after one and two cycles were 0.97 [area under the ROC curve (AUROC): 0.86, 95% confidence interval (CI): 0.70–1.00], <i>p</i> = 0.02] and 1.2 (AUROC: 0.820, 95% CI: 0.664–0.976), respectively. Multivariate analysis identified pretreatment neutrophil-to-lymphocyte ratio (NLR) ≥ 5 [hazard ratio (HR): 6.27, 95% CI: 1.83–21.5, <i>p</i> = 0.004] and TSH ratio after two cycles of &lt; 1.2 (HR: 3.25, 95% CI: 1.25–8.46, <i>p</i> = 0.02) as independent predictors of PFS.</p> Conclusion <p>The TSH ratio after two GCD cycles of &lt; 1.2 and a pretreatment NLR ≥ 5 are potential prognostic factors for poor PFS.</p>

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Impact of thyroid-stimulating hormone ratio change on the progression-free survival of patients receiving gemcitabine, cisplatin, and durvalumab therapy for advanced biliary tract cancer

  • 期刊论文

  • 发表日期：

    2026年1月5日

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  • Michinori Matsumoto,
  • Shinji Itoh,
  • Masashi Tsunematsu,
  • Kyohei Yugawa,
  • Kenei Furukawa,
  • Koichiro Haruki,
  • Yoshihiro Shirai,
  • Tomohiko Taniai,
  • Mitsuru Yanagaki,
  • Ryoga Hamura,
  • Tadashi Uwagawa,
  • Norimitsu Okui,
  • Yoshiaki Tanji,
  • Munetoshi Akaoka,
  • Tomoharu Yoshizumi,
  • Toru Ikegami

摘要

Purpose

To investigate the independent predictors of progression-free survival (PFS) after gemcitabine, cisplatin, and durvalumab (GCD) therapy for advanced biliary tract cancer (BTC), including the thyroid-stimulating hormone (TSH) ratio pre- and post-GCD.

Methods

The subjects of this retrospective analysis were 29 patients receiving GCD for advanced BTC. The cutoff TSH ratios were determined by a receiver operating characteristic (ROC) curve for PFS. The independent predictors of PFS after GCD were determined by univariate and multivariate analyses.

Results

The median PFS was 4.9 (range, 0.9–16.8) months. The objective response and disease control rates were 13.0% and 52.2%, respectively. The cutoff values of the TSH ratio after one and two cycles were 0.97 [area under the ROC curve (AUROC): 0.86, 95% confidence interval (CI): 0.70–1.00], p = 0.02] and 1.2 (AUROC: 0.820, 95% CI: 0.664–0.976), respectively. Multivariate analysis identified pretreatment neutrophil-to-lymphocyte ratio (NLR) ≥ 5 [hazard ratio (HR): 6.27, 95% CI: 1.83–21.5, p = 0.004] and TSH ratio after two cycles of < 1.2 (HR: 3.25, 95% CI: 1.25–8.46, p = 0.02) as independent predictors of PFS.

Conclusion

The TSH ratio after two GCD cycles of < 1.2 and a pretreatment NLR ≥ 5 are potential prognostic factors for poor PFS.