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After revisions, two reviewers agreed to publish the manuscript. There is one reviewer left with a minor revision, and I think the author has responded adequately. I also reviewed the manuscript and found no obvious risks to publication. Therefore, I also approved the publication of this manuscript.
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The authors are requested to carefully revise the manuscript and answer the final questions raised by the reviewers.
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It is crucial to develop robust and reliable biomarkers in predicting the efficacy of ICI-based therapies in AGC patients. In this manuscript, the author studied the correlation between inflammatory and nutritional status and clinical outcomes of ICI-based therapies of patients with AGC. The paper reported many inflammatory and nutritional factors such as NLR, PLR, HALP score, which are informative and preliminarily demonstrates the potential of these inflammatory and nutritional factors as predictors of the efficacy and prognosis in patients with ICI-based therapies for AGC. The basic reporting is clear to me.
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The results shown here is preliminary to me. Further investigation are needed to validate these findings. For example, some of the inflammatory and nutritional factors are correlated and maybe a secondary effect.
Figure 3, 4 and 5 legend: P < 0.05. The “<” is not displayed properly in pdf.
Figure 5, the "∆" in the figure is not displayed properly in pdf. .
The authors are requested to carefully revise the manuscript and answer the questions raised by the reviewers.
There are too many articles related to the index, and the author only included 88 patients receiving immunotherapy, which is extremely unstable. I think it lacks novelty and the results are unclear.
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The number of cases involved in the authors' article is too small. It is suggested to increase the number of cases to more strongly support the findings.
Can the authors provide data on nutritional indicators in a control group of patients who did not receive immune checkpoint inhibitors?
We hope that the authors can further explain the relationship between the clinical characteristics of patients and the therapeutic effect, and analyze whether different clinical types of gastric cancer interfere with the prognosis.
The authors' study is meaningful for the prognosis of clinical gastric cancer patients, and the data have been carefully recorded and organized. However, the language of the article needs improvement, so we suggest that the author ask a native English speaker colleague to help improve the manuscript.
1.The current manuscript would benefit from further editing by a professional language service or a native English speaker.
2.It is recommended that a flowchart be added to this study to clearly display the steps and criteria for participant inclusion and exclusion.
1.The introduction is too lengthy and some of the background should be covered in detail, e.g. current studies have described that PD-L1 CPS, microsatellite instability-high (MSI-H), and Epstein-Barr virus (EBV) can predict the efficacy of ICI-based therapies, but their predictive abilities are not optimal (Liu et al. 2023)”. Some backgrounds should be described briefly, e.g. Recently, immune checkpoint inhibitors (ICIs) have become the preferred treatment choice for AGC. The authors then cite the results of a number of large studies.
2.Materials & Methods：A total of 88 AGC patients diagnosed between September 2019 and December 2022 were included in this retrospective study. There are only inclusion criteria and no exclusion criteria. How many patients were excluded and for what reason should be detailed, which will make your experimental method more credible and scientific, for example, lost follow-up or missing some important information.
3.The article lacks some detailed descriptions of data collection, which affects the authenticity and reliability of the article's data, e.g. how long before and after treatment were the patient's inflammation indicators collected?
3.As the authors mentioned in the introduction, it currently appears that a single indicator is not sufficient to evaluate the efficacy of ICIs and the prognosis of AGC patients. Therefore, the innovation of the article should be the integration of multiple indicators to improve the predictive power of ICI treatment. Can the establishment of a comprehensive predictive model by combining multiple indicators further improve the accuracy of the prediction?
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