Jiang C, Zhang ZH, Li JX. Consideration on immunotherapy of liver metastases of malignant tumors. World J Gastrointest Surg 2024; 16(8): 2374-2381 [PMID: 39220060 DOI: 10.4240/wjgs.v16.i8.2374]
Corresponding Author of This Article
Jia-Xin Li, MD, Assistant Professor, Chief Doctor, Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, and State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu 610041, Sichuan Province, China. lijiaxin@scu.edu.cn
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. Aug 27, 2024; 16(8): 2374-2381 Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2374
Consideration on immunotherapy of liver metastases of malignant tumors
Chuang Jiang, Zhi-Hong Zhang, Jia-Xin Li
Chuang Jiang, Zhi-Hong Zhang, Jia-Xin Li, Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, and State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jia-Xin Li, Department of General Surgery, Dafang County People's Hospital, Bijie 551600, Guizhou Province, China
Author contributions: Jiang C, Zhang ZH, and Li JX contributed to this paper; Jiang C designed the overall concept and outline of the manuscript; Zhang ZH and Li JX contributed to the discussion and design of the manuscript; Jiang C and Li JX contributed to the writing and editing of the manuscript, and review of the literature.
Supported bythe Project of Guizhou Provincial Department of Science and Technology, No. Qian Ke He Cheng Guo LC[2024]109.
Conflict-of-interest statement: All the authors declare no conflict of interest related to 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: Jia-Xin Li, MD, Assistant Professor, Chief Doctor, Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, and State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu 610041, Sichuan Province, China. lijiaxin@scu.edu.cn
Received: March 10, 2024 Revised: May 5, 2024 Accepted: June 3, 2024 Published online: August 27, 2024 Processing time: 159 Days and 1.7 Hours
Abstract
In this editorial, we comment on the article “Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis” by Liu et al that was published in the recent issue of the World Journal of Gastrointestinal Surgery. It has prompted us to think and summarize some thoughts on immunotherapy for malignant tumor liver metastasis. Immunotherapy plays a crucial role in the treatment of malignant tumors; however, the presence of liver metastases in advanced tumors may impact its efficacy. Although patients with liver metastases can still benefit from immunotherapy, multiple clinical studies have indicated that, compared to other sites of metastasis, liver metastases may diminish the effectiveness of immunotherapy. The efficacy of immune checkpoint inhibitors in patients with liver metastases often fails to reach the ideal level, primarily due to the liver metastases exploiting the host's peripheral immune tolerance mechanisms to promote systemic CD8(+) T cell exhaustion, resulting in a systemic immune-tolerant environment. This article aims to summarize the reasons for the decreased efficacy of immunotherapy following liver metastasis in various malignant tumors and propose potential clinical strategies for management.
Core Tip: Immunotherapy is an important treatment method for solid tumors nowadays. However, liver metastasis leads to a decrease in the efficacy of immunotherapy for malignant tumors. The main reason is that liver metastasis can promote the depletion of systemic CD8(+) T cells by utilizing the host's peripheral immune tolerance mechanism, thereby leading to a systemic immune tolerance environment. In the dilemma of limited efficacy of immunotherapy alone, the combination with chemotherapy, radiotherapy, targeted therapy, and other anti-tumor methods can significantly enhance the efficacy of immunotherapy, holding important clinical prospects.
