Abstract
Advanced gastric cancer (GC) remains a high-mortality malignancy despite progress in diagnosis and treatment, including immunotherapy. Reliable prognostic markers are essential for better patient stratification. The triglyceride-glucose (TyG) index, a marker of insulin resistance, has shown promise in various cancers, but its role in GC remains unclear. Yao et al investigated its prognostic value in 300 patients with advanced GC receiving immunotherapy and chemotherapy. Their model, which integrates the TyG index, programmed death-ligand 1 expression, and Eastern Cooperative Oncology Group performance status, underscores the impact of metabolic dysfunction on immune response and treatment efficacy. This letter examines the TyG index's potential as a prognostic tool in GC and its implications for treatment strategies guided by metabolic and immune factors, as demonstrated in Yao et al research.