AUTHOR=Liang Huayuan , Li Zhiwei , Huang Zhicheng , Wu Chaorui , Qiu Yaopeng , Liang Yanrui , Chen Xinhua , Li Fengping , Xu Zhou , Li Guoxin , Liu Hao , Zhao Liying 

TITLE=Prognostic characteristics and clinical response to immunotherapy targeting programmed cell death 1 for patients with advanced gastric cancer with liver metastases

JOURNAL=Frontiers in Immunology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.1015549

DOI=10.3389/fimmu.2022.1015549

ISSN=1664-3224

ABSTRACT=Background: The specific efficacy of immunotherapy for patients with liver metastases of gastric cancer is unclear. This study set out to explore the treatment response and related prognostic factors for patients with liver metastases of gastric cancer treated with immunotherapy.
Patients and methods: This retrospective cohort study included 135 patients with unresectable advanced gastric cancer. According to the presence of liver metastases and/or first-line treatment with immunotherapy, patients were divided into the following three groups: I-LM(-) group(patients without liver metastases treated with immunotherapy)(66 patients), I-LM(+) group(patients with liver metastases treated with immunotherapy)(36 patients), C-LM(+) group(patients with liver metastases treated with chemotherapy)(33 patients). Cox regression analyses were used to identify factors associated with survival in all patients and the three groups, respectively.
Results: For the patients with liver metastases treated with immunotherapy, multivariate analysis showed that only the presence of peritoneal metastases was significantly associated with worse PFS (HR, 3.23; 95% CI, 1.12-9.32; P=0.030) and the patients with peritoneal metastases had shorter median PFS than patients without peritoneal metastases(18.4 vs 3.1 months; p=0.004), while the objective response rate was 100% in patients with HER2-positive (2 complete radiographic responses and 2 partial responses; three of 4 patients were still ongoing benefits[median follow-up time, 15.3 months (IQR, 6.3-17.9 months)]).
Conclusions: The findings suggest that patients with various types of gastric cancer liver metastases may respond differently to immune checkpoint inhibitors, the HER2-positive patients may derive clinical benefits from immune checkpoint inhibitors, while the presence of peritoneal metastases was associated with resistance.