HALP Score as a Predictor of Neoadjuvant Chemotherapy Response in Gastric and Gastroesophageal Junction Adenocarcinoma

Objective: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score reflects inflammation and nutrition and has predictive value in cancers. This study investigates the relationship between HALP score and neoadjuvant chemotherapy (NAC) response in resectable gastric adenocarcinoma (GA) and gastroesophageal junction (GEJ) adenocarcinomas. Material and Methods: This retrospective, single-center study analyzed patients with resectable GEJ or GA undergoing NAC. Patients were grouped as treatment response positive (TR+) and treatment response negative (TR-). HALP scores, calculated prior to treatment, were categorized using a receiver operating characteristic (ROC)-derived cut-off, and their association with treatment response was evaluated. Results: A total of 67 patients (median age 61, 73.1% male) were analyzed, with 36 (53.7%) showing TR+ and 31 (46.2%) showing TR-. ROC analysis revealed a significant association between HALP score and TR+ (area under the curve: 0.708, p=0.004). Older age [odds ratio (OR): 2.87, p=0.046], cN0-1 (OR: 3.43, p=0.023), and higher HALP score (OR: 5.55, p=0.001) were associated with a higher likelihood of TR+. Median progression-free survival (PFS) was 26.7 months [95% confidence interval (CI): 14.7-38.7], and median overall survival (OS) was 43.8 months (95% CI: 27.9-59.8) for the entire cohort. The high HALP group had improved PFS [27.1 months (95% CI: 12.1-41.9) vs. 23.6 months (95% CI: 4.6-42.7), p=0.120] and OS [38.4 months (95% CI: 18.2-58.5) vs. 43.8 months (95% CI: 17.9-69.8), p=0.270], although not statistically significant. Conclusion: HALP score may serve as a predictive marker for NAC response in GEJ and GA, with potential implications for patient stratification.