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Published on: September 12, 2019
Gastric cancer liver metastasis will reduce the efficacy of immunotherapy
Liang Wang1, Shan-Shan Liu2, Sheng-Mei Zhang2
1Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China. wangliang19911128@163.com.
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.
Insights
Immune checkpoint inhibitors show promise in cancer treatment but are less effective when liver tumors develop. Overcoming liver immune suppression is key to improving immunotherapy outcomes for gastric cancer patients with liver metastasis.
Area of Science:
- Immunology
- Oncology
- Medical Science
Background:
- Immune checkpoint inhibitors (ICIs) enhance T cell antitumor activity, proving effective in various cancers like non-small cell lung cancer and melanoma.
- Secondary liver tumors can reduce the liver's responsiveness to immunotherapy and induce systemic immune suppression, diminishing treatment efficacy.
- Patients with non-small cell lung cancer and melanoma receiving immunotherapy experience worse outcomes with liver metastasis.
Discussion:
- Liver metastasis in gastric cancer (GC) patients may signal reduced immunotherapy effectiveness.
- The presence of secondary liver tumors negatively impacts immunotherapy response rates, progression-free survival, and overall survival.
- Liu's retrospective analysis offers insights into managing these complex cases.
Key Insights:
- Liver tumors create an immunosuppressive microenvironment, hindering T cell function.
- Reduced sensitivity to immunotherapy in the liver is a significant clinical challenge.
- Gastric cancer with liver metastasis presents a specific hurdle for effective immunotherapy.
Outlook:
- Strategies to overcome liver immune tolerance are crucial for enhancing immunotherapy benefits.
- Targeting liver-specific immune mechanisms could improve treatment for GC patients with liver metastasis.
- Further research is needed to optimize immunotherapy in the context of liver metastasis.
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