Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis

Abstract

BACKGROUND Gastric cancer (GC) is the fifth most common type of cancer and has the fourth highest death rate among all cancers. There is a lack of studies examining the impact of liver metastases on the effectiveness of immunotherapy in individuals diagnosed with GC. AIM To investigate the influence of liver metastases on the effectiveness and safety of immunotherapy in patients with advanced GC. METHODS This retrospective investigation collected clinical data of patients with advanced stomach cancer who had immunotherapy at our hospital from February 2021 to January 2023. The baseline attributes were compared using either the Chi-square test or the Fisher exact probability method. The chi-square test and Kaplan-Meier survival analysis were employed to assess the therapeutic efficacy and survival duration in GC patients with and without liver metastases. RESULTS The analysis comprised 48 patients diagnosed with advanced GC, who were categorized into two groups: A liver metastasis cohort (n = 20) and a non-liver metastatic cohort (n = 28). Patients with liver metastasis exhibited a more deteriorated physical condition compared to those without liver metastasis. The objective response rates in the cohort with metastasis and the cohort without metastasis were 15.0% and 35.7% (P > 0.05), respectively. Similarly, the disease control rates in these two cohorts were 65.0% and 82.1% (P > 0.05), respectively. The median progression-free survival was 5.0 months in one group and 11.2 months in the other group, with a hazard ratio of 0.40 and a significance level (P ) less than 0.05. The median overall survival was 12.0 months in one group and 19.0 months in the other group, with a significance level (P ) greater than 0.05. CONCLUSION Immunotherapy is less effective in GC patients with liver metastases compared to those without liver metastasis.

Impact of immunotherapy on liver metastasis

“…In research of renal cell carcinoma and melanoma, Kaplan-Meier analysis also presented longer OS and PFS in non-LM patients receiving systemic therapy[ 8 , 9 ]. In the latest issue of the World Journal of Gastrointestinal Surgery , Liu et al [ 10 ] found that immunotherapy was less effective in patients with advanced gastric cancer and LM, which expanded the findings to gastric cancer.…”

Immunotherapy Based on Immune Checkpoint Molecules and Immune Checkpoint Inhibitors in Gastric Cancer–Narrative Review

“…Another problem that may make immunotherapy impossible or reduce its effectiveness is the stage of advancement and the presence of GC metastases. Interestingly, Liu et al [ 20 ] showed that immunotherapy is less effective in patients with GC with liver metastases compared with those without liver metastasis.…”

“…Interactions between immune checkpoint molecules PD-1 or CTLA-4 and their receptors on immune system cells are presented in Figure 2. [20] showed that immunotherapy is less effective in patients with GC with liver metastases compared with those without liver metastasis.…”

Immunotherapy in gastric cancer with liver metastasis: Challenges and opportunities

“…Digestive system tumors, including colorectal cancer (HR: 1.35, 95%CI: 1.07-1.71) and gastric/esophagogastric cancer (HR: 1.17, 95%CI: 0.90-1.52), were less affected. In a retrospective study by Liu et al [ 17 ], which is the focus of this editorial, 48 patients were included, 20 of whom had liver metastases. The objective response rates were 15.0% and 35.7% in the metastatic and nonmetastatic cohorts, respectively ( P > 0.05).…”