Introduction: Therapists must select the best treatment appropriate for the patient. We conducted clinical trials to identify potential human leukocyte antigens (HLAs) in response to cancer treatment.

Patients and Methods: We recruited participants (n = 2,035) who had undergone resection surgery (RS) and HLA testing, had a confirmed family history (FH) of cancer, and received polysaccharide-K (PSK), fluoropyrimidine antimetabolites (FA), mitomycin C (MMC), and their combination therapies as a postoperative adjuvant therapy (PAT). We classified good or poor survival peptide groups matching the human endogenous retrovirus genes (HERVs) according to therapies and FH groups. Subsequently, we assessed the HLA incidence of peptide groups between patients with good and poor survival. We investigated the overall survival of these HLA antigens. Similarly, FH groups and sex differences FH evaluated the relation to HLA-A-locus-based HLAs.

Results: We predicted how the HLAs of an individual patient responded to treatments such as RS only, FA, PSK, MMC, and their combination (MFPSK). In addition, we investigated how the HLA antigens of an individual patient did not respond to RS only. In particular, positive for the HLA-A2 related to good response to FA, PSK, MMC, and MFPSK, while poor response to RS only.

Conclusion: We confirmed the clinical significance of HLA testing; however, this depended on the association with peptides, sex, and their FH. These associations enabled the prediction of treatment response, in particular, the response or non-response to RS only, which was never achieved even by other genomic sciences.

Introduction: The albumin-to-globulin ratio (AGR) has been extensively studied as a predictor of the clinical outcomes of various tumors including gastric cancer (GC). Meanwhile, the predictive performance of the albumin-lymphocyte-globulin-C-reactive protein (ALGC) index has not yet been examined for GC. We investigated the clinical relevance of the preoperative ALGC index in patients undergoing curative surgery for GC, alongside the AGR and five other well-established inflammatory/nutritional parameters.

Methods: We included 157 consecutive patients undergoing R0/R1 gastrectomy for GC. We retrospectively assessed the associations of these preoperative laboratory data indices with clinicopathological characteristics, postoperative complications and survival outcomes, employing receiver operating characteristic (ROC) curves, logistic regression and the Cox proportional hazards model.

Results: With ROC curves, the preoperative ALGC index had the largest area under the curve among seven examined indices. The preoperative ALGC index was significantly related to postoperative complications and the association remained independent even in a multivariate model (odds ratio 0.847 per 1-unit increase, 95% confidence interval 0.694-0.979, P = 0.021), while the other six indices did not. In univariate survival analyses, the preoperative ALGC index showed significant correlations with both overall and relapse-free survivals. There were, however, no independent relationships of the ALGC index with survival outcomes on multivariate analysis.

Conclusions: A lower preoperative ALGC index independently predicted adverse short-term outcomes following gastrectomy for GC, demonstrating superior predictive accuracy compared to other established parameters. Risk stratification using the ALGC index may help identify patients at increased risk of postoperative morbidity and thereby support individualized treatment strategies.