Baseline serum cortisol as a prognostic biomarker for immune checkpoint inhibitor therapy in advanced gastric cancer - Summary - MDSpire

Baseline serum cortisol as a prognostic biomarker for immune checkpoint inhibitor therapy in advanced gastric cancer

  • By

  • Yufei Zhao

  • Zhanjun Guo

  • Jingjing Zhang

  • Zhidong Zhang

  • May 13, 2026

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Objective:

To evaluate the prognostic value of baseline serum cortisol and ACTH levels in predicting immune checkpoint inhibitor (ICI) response in advanced gastric cancer (AGC) patients, highlighting their potential role in treatment personalization.

Key Findings:
  • Median PFS was 7.0 months and median OS was 14.5 months.
  • Low-cortisol group had significantly higher DCR (93.9% vs. 74.3%, P = 0.016) and longer median PFS (10.3 vs. 5.7 months, P = 0.047).
  • High baseline cortisol was an independent prognostic factor for poorer OS (HR=2.03, P = 0.035) and showed a trend for shorter PFS (HR=1.64, P = 0.050).
  • The overall response rate (ORR) was 15.7%.
Interpretation:

Baseline serum cortisol levels are significantly associated with ICI efficacy in AGC, with high levels correlating to poorer clinical outcomes, suggesting a need for tailored treatment approaches.

Limitations:
  • Single-center study may limit generalizability.
  • Retrospective design may introduce selection bias.
  • Potential confounding factors were not addressed.
Conclusion:

Baseline serum cortisol is a promising prognostic biomarker for ICI response in AGC, warranting further investigation into stress hormone signaling in immunotherapy optimization.

Original Source(s)

Baseline serum cortisol as a prognostic biomarker for immune checkpoint inhibitor therapy in advanced gastric cancer

  • by Yufei Zhao, Zhanjun Guo, Jingjing Zhang, Zhidong Zhang

  • May 13, 2026

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