ArticleBMC cancer2019
Sites of metastasis and association with clinical outcome in advanced stage cancer patients treated with immunotherapy.
Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
82 citing papers in PubMed, 4 syntheses or guidelines pooled it, 122 citations in OpenAlex.
- Age-Related Survival Disparities in Advanced Renal Carcinoma in the Immune Checkpoint Inhibitor Era using the SEER Database and Meta-analysis.Scientific reports · 2025Pooled it
- Efficacy and safety of immune checkpoint inhibitors for hepatocellular carcinoma patients with macrovascular invasion or extrahepatic spread: a systematic review and meta-analysis of 54 studies with 6187 hepatocellular carcinoma patients.Cancer immunology, immunotherapy : CII · 2023Pooled it
- Anti-PD-1 and Anti-PD-L1 in Head and Neck Cancer: A Network Meta-Analysis.Frontiers in immunology · 2021Pooled it
- Evaluation of the Prognostic Role of Liver Metastases on Patient Outcomes: Systematic Review and Meta-analysis.Cancer journal (Sudbury, Mass.)Pooled it
- Trial
- Metastatic sites of baseline as predictors in recurrent or metastatic nasopharyngeal carinoma treated with PD-L1 inhibitor: a secondary analysis of multicenter, single-arm, phase II study (KL-A167).Cancer immunology, immunotherapy : CII · 2025Trial
- Trial
- Liver Metastases and Immune Checkpoint Inhibitor Efficacy in Patients With Refractory Metastatic Colorectal Cancer: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2023Trial
- A phase 1-2 trial of sitravatinib and nivolumab in clear cell renal cell carcinoma following progression on antiangiogenic therapy.Science translational medicine · 2022Trial
- Palmitate promotes liver metastases by decreasing neutrophil antitumour behaviour.Nature metabolism · 2026Article
- Comprehensive analysis of prognostic biomarkers for immunotherapy response in patients with advanced malignant melanoma.Translational cancer research · 2026Article
- PD-L1 Expression as a Predictor of Time to Progression in Metastatic Non-Small Cell Lung Cancer Treated with Immune Checkpoint Inhibitors: A Retrospective Single-Center Study.Journal of clinical medicine · 2026Article
- Impact of immunochemotherapy administration sequence on overall survival in advanced esophageal and gastric cancers: a propensity score-matched multicenter analysis.Cancer immunology, immunotherapy : CII · 2026Observational
- Clinical, Dermatoscopic, Histological and Molecular Prognostic and Predictive Factors of Metastatic Melanoma Response to Immunotherapy: A Systematic Review and Drug Class Meta-Analysis.Journal of clinical medicine · 2026Review
- Site and number of metastases predict outcomes in avelumab maintenance for advanced UC: results from meet-URO 25.Cancer immunology, immunotherapy : CII · 2026Observational
- Broad Utility of Ultrasensitive Analysis of ctDNA Dynamics across Solid Tumors Treated with Immunotherapy.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Efficacy and Safety of Low-Dose Hypofractionated Radiotherapy Combined with Immunotherapy for Liver Metastases: A Single-Center Retrospective Analysis.OncoTargets and therapy · 2026Article
- Tissue-specific antitumor NK cell subsets identified in colorectal cancer liver metastases express candidate therapeutic targets.The Journal of clinical investigation · 2025Article
- Organ-Specific Responses to Nivolumab Plus Ipilimumab in Advanced Hepatocellular Carcinoma: A Multicenter, Retrospective Study.Cancer medicine · 2025Article
- Natural Language Processing of Radiology Reports to Assess Survival in Patients with Advanced Melanoma.Cancers · 2025Article
22 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSelecting the appropriate patients to receive immunotherapy (IO) remains a challenge due to the lack of optimal biomarkers. The presence of liver metastases has been implicated as a poor prognostic factor in patients with metastatic cancer. We investigated the association between sites of metastatic disease and clinical outcomes in patients receiving IO.
methodsWe conducted a retrospective review of 90 patients treated on IO-based phase 1 clinical trials at Winship Cancer Institute of Emory University between 2009 and 2017. Overall survival (OS) and progression-free survival (PFS) were measured from the first dose of IO to date of death or hospice referral and clinical or radiographic progression, respectively. Clinical benefit (CB) was defined as a best response of complete response (CR), partial response (PR), or stable disease (SD). Univariate analysis (UVA) and Multivariate analysis (MVA) were carried out using Cox proportional hazard model or logistic regression model. Covariates included age, whether IO is indicated for the patient's histology, ECOG performance status, Royal Marsden Hospital (RMH) risk group, number of metastatic sites, and histology.
resultsThe median age was 63 years and 53% of patients were men. The most common histologies were melanoma (33%) and gastrointestinal cancers (22%). Most patients (73.3%) had more than one site of distant metastasis. Sites of metastasis collected were lymph node (n = 58), liver (n = 40), lung (n = 37), bone (n = 24), and brain (n = 8). Most patients (80.7%) were RMH good risk. Most patients (n = 62) had received 2+ prior lines of systemic treatment before receiving IO on trial; 27 patients (30.0%) received prior ICB. Liver metastases were associated with significantly shorter OS (HR: 0.38, CI: 0.17-0.84, p = 0.017). Patients with liver metastasis also trended towards having shorter PFS (HR: 0.70, CI: 0.41-1.19, p = 0.188). The median OS was substantially longer for patients without liver metastases (21.9 vs. 8.1 months, p = 0.0048).
conclusionsLiver metastases may be a poor prognostic factor in patients receiving IO on phase 1 clinical trials. The presence of liver metastases may warrant consideration in updated prognostic models if these findings are validated in a larger prospective cohort.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.