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Meta-Analysis
. 2024 Nov 1;8(6):pkae105.
doi: 10.1093/jncics/pkae105.

Role of immunotherapy in gastroesophageal cancer with liver metastasis

Sawyer Bawek  1   2 , Mrinalini Ramesh  1 , Sayuri Gurusinghe  1 , Ali Aijaz  1 , Kristopher Attwood  3 , Nariman Hossein-Javaheri  1 , Sarbajit Mukherjee  2
Affiliations
Meta-Analysis

Role of immunotherapy in gastroesophageal cancer with liver metastasis

Sawyer Bawek et al. JNCI Cancer Spectr. .

Abstract

The role of immune checkpoint inhibitors for patients with gastroesophageal cancer with liver metastasis remains unclear. Our objective was to investigate whether immune checkpoint inhibitors are beneficial in patients with gastroesophageal cancer with liver metastasis. We searched PubMed, Embase, European Society for Medical Oncology, and American Society of Clinical Oncology meeting abstracts for phase 3 randomized clinical trials testing immune checkpoint inhibitors in metastatic/advanced gastroesophageal cancer from 2017 to 2023. Seven studies were included. Overall survival was similar among all patients (hazard ratio [HR] = 0.72 [95% confidence interval (CI) = 0.67 to 0.77], P < .001), in patients without liver metastases (HR = 0.73 [95% CI = 0.67 to 0.81], P < .001, I2 = 0.0%), and in patients with liver metastases (HR = 0.74 [95% CI = 0.67 to 0.81], P < .001, I2 = 0.0%). Progression-free survival was also similar among all patients (HR = 0.63 [95% CI = 0.57 to 0.70], P < .001), in patients without liver metastases (HR = 0.62 [95% CI = 0.51 to 0.76], P < .001), and in patients with liver metastases (HR = 0.66 [95% CI = 0.57 to 0.76], P < .001). Immune checkpoint inhibitors showed no difference in benefit in patients with gastroesophageal cancer, regardless of liver metastasis. Future studies could focus on deciphering the tumor microenvironment of liver metastasis as an area of translational research.

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Conflict of interest statement

Sarbajit Mukherjee is a volunteer guidelines panel member at the National Comprehensive Cancer Network and American Society of Clinical Oncology. He received research funding from the National Comprehensive Cancer Network and Ipsen Biopharmaceuticals/North American Neuroendocrine Tumor Society, which were paid to the institute. Dr Mukherjee received consulting fees from Merck and BeiGene, Ltd. Sarbajit Mukherjee and all other authors declare no author conflicts of interest.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram showing study selection.
Figure 2.
Figure 2.
Overall survival and PFS for patients with liver metastasis, without liver metastasis, and all patients. Overall survival (top) was similar among all patients (HR = 0.72, P < .001, I2 = 0.0%), patients with no liver metastasis (HR = 0.73, P < .001, I2 = 0.0%), and patients with liver metastasis (HR = 0.74, P < .001, I2 = 0.0%), indicating that immune checkpoint inhibitors’ benefit on overall survival is consistent. PFS (bottom) was also similar among all patients (HR = 0.63, P < .001, I2 = 54.7%), among patients without liver metastasis (HR = 0.62, P < .001, I2 = 62.3%), and patients with liver metastasis (HR = 0.66, P < .001, I2 = 0.0%). HR = hazard ratio; PFS = progression-free survival; CI = Confidence Interval.
See this image and copyright information in PMC

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