Wang Liang, Liu Shan-Shan, Zhang Sheng-Mei, Chen Xiao-Qian, Huang Tao, Tian Rong, Zhao Ya-Qi, Chen Zhou, Xianba Cai-Rang
Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China.
Intensive Care Unit, The Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China.
World J Gastrointest Surg. 2024 Sep 27;16(9):2760-2764. doi: 10.4240/wjgs.v16.i9.2760.
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.
免疫检查点抑制剂通过抑制T细胞的负调节途径增强T细胞的抗肿瘤活性，通过免疫治疗的应用，在非小细胞肺癌、黑色素瘤和其他恶性肿瘤患者中产生显著疗效。然而，继发性恶性肝肿瘤不仅会降低肝脏对免疫治疗的敏感性，还会引发全身免疫抑制，导致免疫治疗的总体效果降低。当非小细胞肺癌和黑色素瘤患者发生继发性肝恶性肿瘤时，接受免疫治疗的患者的缓解率、无进展生存期和总生存期都会降低。通过刘的回顾性分析，为这些患者未来的临床管理提供了有价值的见解。因此，在胃癌（GC）患者中，肝转移的发生可能表明免疫治疗效果降低。克服肝脏免疫耐受机制及其负面影响，可能使GC伴肝转移患者从免疫治疗中获益。
