ArticleJournal for immunotherapy of cancer2022
Ascites and resistance to immune checkpoint inhibition in dMMR/MSI-H metastatic colorectal and gastric cancers.
Article in Journal for immunotherapy of cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 3 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
74 citing papers in PubMed, 3 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Impact of metastatic pattern and histologic subtype on PD-(L)1 inhibitor efficacy in HER2-negative advanced gastric and gastroesophageal cancer: a meta-analysis.Frontiers in oncology · 2026Pooled it
- Does Malignant Ascites Define Prognosis in Gastric Cancer with Peritoneal Spread? A Systematic Review and Meta-analysis.Journal of gastrointestinal cancer · 2025Pooled it
- Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer.Journal for immunotherapy of cancer · 2023Guideline
- Toripalimab, bevacizumab, and irinotecan in dMMR/MSI locally advanced colorectal cancer: First-stage results from a phase 1b/2 trial.Cell reports. Medicine · 2025Trial
- Resistance Phenotypes and Treatment Sequencing After Immune Checkpoint Blockade in MSI-H/dMMR Metastatic Colorectal Cancer: A Review.Journal of gastrointestinal cancer · 2026Review
- Immunotherapy resistance in colorectal cancer: therapeutic strategies and biomarker-guided approaches.Cancer cell international · 2026Review
- Review
- Checkpoint inhibitors in microsatellite instability-high metastatic colorectal cancer: treatment strategies, specificities, and care management questions.ESMO gastrointestinal oncology · 2026Review
- Immunological Insights into Peritoneal Carcinomatosis for Gastrointestinal Malignancies: The Role of Soluble Factors in Malignant Ascites.Biomedicines · 2026Article
- Clinical characteristics, treatment response, and survival outcomes in melanoma patients with cavity carcinomatosis: A retrospective analysis.International journal of cancer · 2026Article
- Mucinous histology and resistance to immune checkpoint blockade in patients with microsatellite instability-high metastatic colorectal cancer.The oncologist · 2026Article
- Clinical risk factors associated with poor prognosis in gastric cancer patients with peritoneal metastasis.Medicine · 2026Article
- Emerging immunotherapeutic strategies for malignant serous effusions: current evidence and future directions.Frontiers in oncology · 2026Review
- Breaching the immune-cold barrier in pMMR/MSS metastatic colorectal cancer: emerging strategies beyond standard care.Frontiers in immunology · 2026Review
- Macrophage states and immunometabolic adaptation in peritoneal metastases from colorectal cancer.Frontiers in immunology · 2026Review
- Identification of VVD-214/RO7589831, a Clinical-Stage, Covalent Allosteric Inhibitor of WRN Helicase for the Treatment of MSI-High Cancers.Journal of medicinal chemistry · 2025Article
- Gastrointestinal cancer: molecular pathogenesis and targeted therapy.Molecular biomedicine · 2025Review
- Tumor-draining lymph nodes respond to immune checkpoint inhibition and orchestrate tumor immune remodeling.Cancer immunology, immunotherapy : CII · 2025Article
- Distinct Immunosuppressive Tumor Microenvironment in Gastric Cancer With Peritoneal Metastasis.Journal of gastric cancer · 2025Article
- First-line PD-1 +/- CTLA-4 blockade in patients with deficient mismatch repair and/or microsatellite instability-high metastatic colorectal cancer.The oncologist · 2025Article
14 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
31 authors at 15 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite unprecedented benefit from immune checkpoint inhibitors (ICIs) in patients with mismatch repair deficient (dMMR)/microsatellite instability high (MSI-H) advanced gastrointestinal cancers, a relevant proportion of patients shows primary resistance or short-term disease control. Since malignant effusions represent an immune-suppressed niche, we investigated whether peritoneal involvement with or without ascites is a poor prognostic factor in patients with dMMR/MSI-H metastatic colorectal cancer (mCRC) and gastric cancer (mGC) receiving ICIs.
methodsWe conducted a global multicohort study at Tertiary Cancer Centers and collected clinic-pathological data from a cohort of patients with dMMR/MSI-H mCRC treated with anti-PD-(L)1 ±anti-CTLA-4 agents at 12 institutions (developing set). A cohort of patients with dMMR/MSI-high mGC treated with anti-PD-1 agents±chemotherapy at five institutions was used as validating dataset.
resultsThe mCRC cohort included 502 patients. After a median follow-up of 31.2 months, patients without peritoneal metastases and those with peritoneal metastases and no ascites had similar outcomes (adjusted HR (aHR) 1.15, 95% CI 0.85 to 1.56 for progression-free survival (PFS); aHR 0.96, 95% CI 0.65 to 1.42 for overall survival (OS)), whereas inferior outcomes were observed in patients with peritoneal metastases and ascites (aHR 2.90, 95% CI 1.70 to 4.94; aHR 3.33, 95% CI 1.88 to 5.91) compared with patients without peritoneal involvement. The mGC cohort included 59 patients. After a median follow-up of 17.4 months, inferior PFS and OS were reported in patients with peritoneal metastases and ascites (aHR 3.83, 95% CI 1.68 to 8.72; aHR 3.44, 95% CI 1.39 to 8.53, respectively), but not in patients with only peritoneal metastases (aHR 1.87, 95% CI 0.64 to 5.46; aHR 2.15, 95% CI 0.64 to 7.27) when compared with patients without peritoneal involvement.
conclusionsPatients with dMMR/MSI-H gastrointestinal cancers with peritoneal metastases and ascites should be considered as a peculiar subgroup with highly unfavorable outcomes to current ICI-based therapies. Novel strategies to target the immune-suppressive niche in malignant effusions should be investigated, as well as next-generation ICIs or intraperitoneal approaches.
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.