PDF(Pubmed)
Abstract：
In this editorial, we review the article by Liu et al published in the World Journal of Gastrointestinal Surgery investigating the efficacy and safety of immunotherapy in patients with gastric cancer (GC) and liver metastasis. GC, the fifth most commonly diagnosed malignancy worldwide, presents a significant challenge due to its multifactorial etiology and a grim prognosis for unresectable or recurrent cases. The advent of immune checkpoint inhibitors (ICIs) has revolutionized oncology; yet liver metastasis has been associated with reduced response rates, progression-free survival, and overall survival in various malignancies. The CheckMate-649 and KEYNOTE-859 trials demonstrated promising results with ICIs in advanced GC, particularly in patients with liver metastasis. However, a meta-analysis of liver metastatic solid tumors revealed worse outcomes with ICIs, highlighting the need for further investigation. While combined therapies, including ICIs with local treatments, show promise in improving outcomes, the nuanced landscape of ICIs in liver metastatic GC necessitates continued research for robust conclusions. The current contradictions in the literature underscore the importance of cautious interpretation and the exploration of tailored approaches to enhance clinical efficacy in this challenging patient population.
摘要：
在这篇社论中，我们回顾了Liu等人发表在《世界胃肠外科杂志》上的文章，研究了免疫治疗对胃癌（GC）和肝转移患者的疗效和安全性。GC,全球第五大最常见的恶性肿瘤，由于其多因素病因以及不可切除或复发病例的严峻预后，因此提出了重大挑战。免疫检查点抑制剂（ICIs）的出现彻底改变了肿瘤学;然而，肝转移与降低的反应率有关。无进展生存期,以及各种恶性肿瘤的总体生存率。CheckMate-649和KEYNOTE-859试验证明了ICI在高级GC中的有希望的结果，尤其是肝转移患者。然而,对肝转移性实体瘤的荟萃分析显示，ICIs的预后较差，强调需要进一步调查。虽然联合疗法，包括当地治疗的ICIs，在改善结果方面表现出希望，肝转移性GC中ICIs的细微差别需要继续研究以获得可靠的结论.目前文献中的矛盾强调了谨慎解释和探索定制方法以提高这一具有挑战性的患者人群的临床疗效的重要性。
