Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2760-2764
Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2760
Gastric cancer liver metastasis will reduce the efficacy of immunotherapy
Liang Wang, Shan-Shan Liu, Sheng-Mei Zhang, Xiao-Qian Chen, Tao Huang, Rong Tian, Ya-Qi Zhao, Zhou Chen, Cai-Rang Xianba
Liang Wang, Shan-Shan Liu, Sheng-Mei Zhang, Xiao-Qian Chen, Ya-Qi Zhao, Zhou Chen, Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Tao Huang, Intensive Care Unit, The Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Rong Tian, Department of Ultrasound, The Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Cai-Rang Xianba, Department of General Surgery, Hainan State People's Hospital of Qinghai Province, Hainan Tibetan Autonomous Prefecture 813000, Qinghai Province, China
Co-first authors: Liang Wang and Shan-Shan Liu.
Author contributions: Wang L and Liu SS co-wrote the manuscript, sharing the first authorship; Wang L contributed to the editorial concept and design; Zhang SM, Chen XQ, Huang T, Tian R, Zhao YQ, Chen Z and Xianba CR reviewed the literature; Wang L revised and reviewed the manuscript; all authors have read and approved the final manuscript.
Supported by 2021 Key Topic of Qinghai Provincial Health System – Guiding Plan Topic, No. 2021-WJZDX-43.
Conflict-of-interest statement: Dr. Wang has nothing to disclose.
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: Liang Wang, Doctor, Attending Doctor, Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China.wangliang19911128@163.com
Received: February 28, 2024
Revised: May 6, 2024
Accepted: June 13, 2024
Published online: September 27, 2024
Processing time: 202 Days and 20.4 Hours
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.