Title: Inflammatory and Nutritional Markers Predict Response and Prognosis of Patients with
Locally Advanced Gastric Cancer Receiving Neoadjuvant Immunochemotherapy
Version: 1 Date: 06 Apr 2025
Reviewer's report:
The revised manuscript titled "Inflammatory and Nutritional Markers Predict Response
and Prognosis of Patients with Locally Advanced Gastric Cancer Receiving Neoadjuvant
Immunochemotherapy" addresses an important and timely clinical issue. The authors explore the
prognostic significance of inflammatory and nutritional markers in predicting treatment response
and short-term survival among patients receiving neoadjuvant immunochemotherapy for locally
advanced gastric cancer.
The study is based on a well-characterized cohort and provides useful insights into the integration
of CONUT and NRS2002 scores into clinical evaluation. The construction of a combined
CONUT-NRS2002 score and the development of a nomogram are notable strengths. The authors
have also been responsive to previous reviewer feedback.
Key strengths:
Addresses a clinically relevant question.
Incorporates routinely available, cost-effective markers into the predictive framework.
Nomogram development enhances potential clinical utility.
Remaining suggestions:
Molecular profiling: Although it is understandable that PD-L1, MSI, and EBV status were
not routinely available, these are important biomarkers in gastric cancer and should be
acknowledged as such. The authors have appropriately added this to the Limitations section.
Selection bias and confounders: The exclusion of patients with severe nutritional impairment
(e.g., those receiving parenteral nutrition) introduces potential selection bias. This has now
been acknowledged appropriately. Additional confounders (e.g., perioperative care, nutritional
support, and comorbidities) are also important and are now reflected in the revised Discussion.
Mechanistic discussion: The revised manuscript includes a more detailed interpretation of
the potential biological basis for the association between nutritional/inflammatory status and
immune responsiveness, which improves the scientific depth of the work.
Clinical implications: The authors have moderated the strength of their conclusions and correctly
stated that the prognostic model needs prospective and multi-center validation before it can be
implemented in clinical practice.
Conclusion:
The authors have adequately addressed prior concerns and significantly improved the clarity,
transparency, and clinical relevance of the manuscript. The revised version is acceptable after
minor editorial revisions (language polishing, figure caption improvements). The manuscript is
now suitable for publication.
Title: Inflammatory and Nutritional Markers Predict Response and Prognosis of Patients with
Locally Advanced Gastric Cancer Receiving Neoadjuvant Immunochemotherapy
Version: 1 Date: 06 Apr 2025
Reviewer's report:
The revised manuscript titled "Inflammatory and Nutritional Markers Predict Response
and Prognosis of Patients with Locally Advanced Gastric Cancer Receiving Neoadjuvant
Immunochemotherapy" addresses an important and timely clinical issue. The authors explore the
prognostic significance of inflammatory and nutritional markers in predicting treatment response
and short-term survival among patients receiving neoadjuvant immunochemotherapy for locally
advanced gastric cancer.
The study is based on a well-characterized cohort and provides useful insights into the integration
of CONUT and NRS2002 scores into clinical evaluation. The construction of a combined
CONUT-NRS2002 score and the development of a nomogram are notable strengths. The authors
have also been responsive to previous reviewer feedback.
Key strengths:
Addresses a clinically relevant question.
Incorporates routinely available, cost-effective markers into the predictive framework.
Nomogram development enhances potential clinical utility.
Remaining suggestions:
Molecular profiling: Although it is understandable that PD-L1, MSI, and EBV status were
not routinely available, these are important biomarkers in gastric cancer and should be
acknowledged as such. The authors have appropriately added this to the Limitations section.
Selection bias and confounders: The exclusion of patients with severe nutritional impairment
(e.g., those receiving parenteral nutrition) introduces potential selection bias. This has now
been acknowledged appropriately. Additional confounders (e.g., perioperative care, nutritional
support, and comorbidities) are also important and are now reflected in the revised Discussion.
Mechanistic discussion: The revised manuscript includes a more detailed interpretation of
the potential biological basis for the association between nutritional/inflammatory status and
immune responsiveness, which improves the scientific depth of the work.
Clinical implications: The authors have moderated the strength of their conclusions and correctly
stated that the prognostic model needs prospective and multi-center validation before it can be
implemented in clinical practice.
Conclusion:
The authors have adequately addressed prior concerns and significantly improved the clarity,
transparency, and clinical relevance of the manuscript. The revised version is acceptable after
minor editorial revisions (language polishing, figure caption improvements). The manuscript is
now suitable for publication.
Please review this paper.
user
Title: Inflammatory and Nutritional Markers Predict Response and Prognosis of Patients with
Locally Advanced Gastric Cancer Receiving Neoadjuvant Immunochemotherapy
Version: 1 Date: 06 Apr 2025
Reviewer's report:
The revised manuscript titled "Inflammatory and Nutritional Markers Predict Response
and Prognosis of Patients with Locally Advanced Gastric Cancer Receiving Neoadjuvant
Immunochemotherapy" addresses an important and timely clinical issue. The authors explore the
prognostic significance of inflammatory and nutritional markers in predicting treatment response
and short-term survival among patients receiving neoadjuvant immunochemotherapy for locally
advanced gastric cancer.
The study is based on a well-characterized cohort and provides useful insights into the integration
of CONUT and NRS2002 scores into clinical evaluation. The construction of a combined
CONUT-NRS2002 score and the development of a nomogram are notable strengths. The authors
have also been responsive to previous reviewer feedback.
Key strengths:
Addresses a clinically relevant question.
Incorporates routinely available, cost-effective markers into the predictive framework.
Nomogram development enhances potential clinical utility.
Remaining suggestions:
Molecular profiling: Although it is understandable that PD-L1, MSI, and EBV status were
not routinely available, these are important biomarkers in gastric cancer and should be
acknowledged as such. The authors have appropriately added this to the Limitations section.
Selection bias and confounders: The exclusion of patients with severe nutritional impairment
(e.g., those receiving parenteral nutrition) introduces potential selection bias. This has now
been acknowledged appropriately. Additional confounders (e.g., perioperative care, nutritional
support, and comorbidities) are also important and are now reflected in the revised Discussion.
Mechanistic discussion: The revised manuscript includes a more detailed interpretation of
the potential biological basis for the association between nutritional/inflammatory status and
immune responsiveness, which improves the scientific depth of the work.
Clinical implications: The authors have moderated the strength of their conclusions and correctly
stated that the prognostic model needs prospective and multi-center validation before it can be
implemented in clinical practice.
Conclusion:
The authors have adequately addressed prior concerns and significantly improved the clarity,
transparency, and clinical relevance of the manuscript. The revised version is acceptable after
minor editorial revisions (language polishing, figure caption improvements). The manuscript is
now suitable for publication.
assistant