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

Kai Liu; Chun-Xiao Wu; Hui Liang; Tao Wang; Ji-Yuan Zhang; Xiao-Tao Wang

doi:10.4240/wjgs.v16.i3.700

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

World J Gastrointest Surg. 2024 Mar 27;16(3):700-709. doi: 10.4240/wjgs.v16.i3.700.

Authors

Kai Liu¹, Chun-Xiao Wu², Hui Liang¹, Tao Wang³, Ji-Yuan Zhang⁴, Xiao-Tao Wang⁵

Affiliations

¹ Department of Radiation and Oncology, Traditional Chinese Hospital of Lu'an affiliated to Anhui University of Traditional Chinese Medicine, Lu'an 237000, Anhui Province, China.
² Department of Gastroenterology, Ehu branch of Xishan People's Hospital of Wuxi City, Wuxi 214116, Jiangsu Province, China.
³ Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510400, Guangdong Province, China.
⁴ Department of Gastrointestinal Surgery, Hunan Provincial People's Hospital, Changsha 410002, Hunan Province, China.
⁵ Department of Traditional Chinese medicine, Ehu branch of Xishan People's Hospital of Wuxi City, Wuxi 214116, Jiangsu Province, China. wxtxyjc@163.com.

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.

Keywords: Effectiveness of treatment; Gastric cancer; Spread of cancer to the liver; Treatment with immunotherapy.