Bardakçi M, Ergun Y. Immunotherapy in gastric cancer with liver metastasis: Challenges and opportunities. World J Gastrointest Surg 2024; 16(6): 1513-1516 [PMID: 38983315 DOI: 10.4240/wjgs.v16.i6.1513]
Corresponding Author of This Article
Yakup Ergun, MD, Department of Medical Oncology, Antalya City Hospital, Gocerler Neighborhood, 5379 Street, Antalya 07080, Türkiye. dr.yakupergun@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1513-1516 Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1513
Immunotherapy in gastric cancer with liver metastasis: Challenges and opportunities
Murat Bardakçi, Yakup Ergun
Murat Bardakçi, Department of Medical Oncology, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakir 021000, Kayapinar, Türkiye
Yakup Ergun, Department of Medical Oncology, Antalya City Hospital, Antalya 07080, Türkiye
Author contributions: Bardakci M reviewed the literature and wrote the manuscript; Ergun Y contributed to the discussion and design of the manuscript; all authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: The author(s) declare that there are no potential conflicts of interest with respect to the research, authorship, and/or publication of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yakup Ergun, MD, Department of Medical Oncology, Antalya City Hospital, Gocerler Neighborhood, 5379 Street, Antalya 07080, Türkiye. dr.yakupergun@gmail.com
Received: February 26, 2024 Revised: April 29, 2024 Accepted: May 17, 2024 Published online: June 27, 2024 Processing time: 124 Days and 20 Hours
Abstract
In this editorial, we review the article by Liu et al published in the World Journal of Gastrointestinal Surgery investigating the efficacy and safety of immunotherapy in patients with gastric cancer (GC) and liver metastasis. GC, the fifth most commonly diagnosed malignancy worldwide, presents a significant challenge due to its multifactorial etiology and a grim prognosis for unresectable or recurrent cases. The advent of immune checkpoint inhibitors (ICIs) has revolutionized oncology; yet liver metastasis has been associated with reduced response rates, progression-free survival, and overall survival in various malignancies. The CheckMate-649 and KEYNOTE-859 trials demonstrated promising results with ICIs in advanced GC, particularly in patients with liver metastasis. However, a meta-analysis of liver metastatic solid tumors revealed worse outcomes with ICIs, highlighting the need for further investigation. While combined therapies, including ICIs with local treatments, show promise in improving outcomes, the nuanced landscape of ICIs in liver metastatic GC necessitates continued research for robust conclusions. The current contradictions in the literature underscore the importance of cautious interpretation and the exploration of tailored approaches to enhance clinical efficacy in this challenging patient population.
Core Tip: In the context of gastric cancer patients with liver metastases, the standard treatment often involves combinations of immunotherapy and chemotherapy, particularly in specific patient groups. However, considering the intricate dynamics of the tumor microenvironment, the effectiveness of immunotherapies may be limited in cases of liver metastatic disease. In this context, especially considering the potential benefits of locally targeted treatments to the liver, further research and clinical studies are necessary to expand effective therapeutic options.
