Dehal A. Immunotherapy for gastric cancer and liver metastasis: Is it time to bid farewell. World J Gastrointest Surg 2024; 16(8): 2365-2368 [PMID: 39220066 DOI: 10.4240/wjgs.v16.i8.2365]
Corresponding Author of This Article
Ahmed Dehal, FACS, FRCS, MD, Associate Professor, Surgical Oncologist, Department of Clinical Sciences, Kaiser Permanente School of Medicine, 13652 Cantara Street, Panorama, CA 91402, United States. ahmed.n.dehal@kp.org
Research Domain of This Article
Surgery
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. Aug 27, 2024; 16(8): 2365-2368 Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2365
Immunotherapy for gastric cancer and liver metastasis: Is it time to bid farewell
Ahmed Dehal
Ahmed Dehal, Department of Clinical Sciences, Kaiser Permanente School of Medicine, Panorama, CA 91402, United States
Author contributions: Dehal A designed and wrote the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Ahmed Dehal, FACS, FRCS, MD, Associate Professor, Surgical Oncologist, Department of Clinical Sciences, Kaiser Permanente School of Medicine, 13652 Cantara Street, Panorama, CA 91402, United States. ahmed.n.dehal@kp.org
Received: March 8, 2024 Revised: May 20, 2024 Accepted: June 5, 2024 Published online: August 27, 2024 Processing time: 160 Days and 17.7 Hours
Abstract
Patients with metastatic gastric cancer have a grim prognosis. Palliative chemotherapy offers a limited survival improvement, but recent advancements in immunotherapy have sparked hope. However, the effectiveness of immunotherapy in patients with liver metastases remains debated. This article reviews a recent study by Liu et al and evaluates conflicting evidence on the impact of liver metastases on response to immunotherapy in metastatic gastric cancer. While some studies suggest no significant difference in treatment response based on liver involvement, others report varied response rates. The present study, a retrospective analysis of 48 patients by Liu et al, examines this issue and concludes that immunotherapy is less effective in patients with liver metastases. Despite methodological limitations and a small sample size, the study contributes to the ongoing discourse. The nuanced response to immunotherapy in certain patients underscores the importance of understanding the tumor microenvironment, immune cell infiltration, and the expression of immune checkpoints. Rather than dismissing immunotherapy for patients with gastric cancer and liver metastases, a shift towards personalized treatment strategies and a more profound understanding of tumor-specific biomarkers is essential. By unraveling the molecular intricacies of individual cases, clinicians may tailor more effective and customized treatments, offering a glimmer of hope for this challenging patient group.
Core Tip: The prognosis of patients with gastric cancer and liver metastasis is abysmal. Palliative chemotherapy is associated with a limited survival benefit yet is very toxic. Immunotherapy is considered an emerging promising therapy with some remarkable results. There has been a growing body of literature from animal and human studies that question the efficacy of immunotherapy in these patients. In this article, we discuss this issue and provide a balanced appraisal of the literature.
