Gastric cancer liver metastasis will reduce the efficacy of immunotherapy

Abstract

Immune checkpoint inhibitors augment the antitumor activity of T cells by inhibiting the negative regulatory pathway of T cells, leading to notable efficacy in patients with non-small cell lung cancer, melanoma, and other malignancies through immunotherapy utilization. However, secondary malignant liver tumors not only lower the liver's sensitivity to immunotherapy but also trigger systemic immune suppression, resulting in reduced overall effectiveness of immune therapy. Patients receiving immunotherapy for non-small cell lung cancer and melanoma experience reduced response rates, progression-free survival, and overall survival when secondary malignant tumors develop in the liver. Through Liu's retrospective analysis, valuable insights are provided for the future clinical management of these patients. Therefore, in patients with gastric cancer (GC), the occurrence of liver metastasis might be indicative of reduced efficacy of immunotherapy. Overcoming liver immune tolerance mechanisms and their negative impacts allows for the potential benefits of immunotherapy in patients with GC and liver metastasis.

Keywords: Immune checkpoint inhibitors; Gastric cancer; Gastric cancer with liver metastasis; Immunotherapy; Liver immune tolerance

Core Tip: Immunotherapy has found extensive application in the clinical management of advanced gastric cancer (GC), yielding notable clinical outcomes. In the context of advanced GC with liver metastasis, immunotherapy fails to elicit the desired response owing to the presence of hepatic immune tolerance mechanisms and the compromised physical condition of patients, leading to a reduction in immune response rates. Therefore, liver metastases may be associated with a lower likelihood of immunotherapy success in GC patients. Enhancing the response to immunotherapy in GC patients with liver metastases involves overcoming liver immune tolerance mechanisms and their adverse effects.