A multicenter retrospective study of the combination of immune checkpoint inhibitors and chemotherapy regimens with or without liver metastasis for the first-line treatment of advanced gastric cancer.

Abstract

Background: Several studies have indicated that the use of immune checkpoint inhibitors (ICI) can prolong the survival of patients with advanced gastric cancer (AGC). However, it remains unclear whether the presence of liver metastasis leads to systemic immune suppression, resulting in poorer immune therapy outcomes. This study aims to investigate whether liver metastasis affects the efficacy of ICI in first-line treatment for AGC patients.

Methods: The data of AGC patients undergoing combined immunotherapy and chemotherapy treatment at Harbin Medical University Cancer Hospital and the First Hospital of Shanxi Medical University from January 2018 to January 2023 were collected. The Kaplan-Meier method and Cox proportional hazards regression analysis were employed to analyze the overall survival (OS) and progression-free survival (PFS) of the patients.

Results: A total of 162 patients with AGC who were human epidermal growth factor receptor 2 (Her 2) negative and treated with immunotherapy in the first line were included in the study. Patients were divided into two groups, the liver metastasis group (LM group, n = 40) and the group without liver metastasis (NLM group, n = 122) according to the presence of liver metastasis. The results of the present study indicate that there was no statistically significant difference in the median OS, with median OS of 17 and 15 months, respectively (p = 0.29). Similarly, no significant difference was observed in the median PFS between the two groups (p = 0.65).

Conclusion: This study suggests that the presence or absence of liver metastasis does not significantly affect the prognosis of AGC patients receiving first-line treatment with ICI.