ArticleWorld journal of gastrointestinal oncology2025
Neutrophil extracellular traps predict sensitivity to neoadjuvant chemotherapy combined with immunotherapy in locally advanced gastric cancer.
Article in World journal of gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNeutrophil extracellular traps (NETs) are associated with an immunosuppressive tumor microenvironment and may influence the efficacy of immune-based therapies. However, their role in neoadjuvant chemotherapy combined with immunotherapy (NACI) for locally advanced gastric cancer (LAGC) remains unclear.
aimTo investigate the prognostic and predictive value of NET density in LAGC patients undergoing NACI.
methodsWe enrolled 31 LAGC patients treated with NACI. NET density was assessed through dual immunofluorescence staining of citrullinated histone H3 and myeloperoxidase in pretreatment biopsy and post-treatment surgical specimens. Patients were stratified into high and low pre-NACI NET groups based on median NET density. Pathological complete response (pCR) and overall response rates were evaluated in relation to NET density. Logistic regression analyses were performed to identify independent predictors of treatment outcomes. Dynamic changes in NET density during NACI were also analyzed.
resultsPatients with low pre-NACI NET density demonstrated significantly higher rates of pCR (40%
conclusionPre-NACI NET density serves as a prognostic and predictive biomarker for NACI efficacy in LAGC patients. Low pretreatment NET density is associated with favorable outcomes, while increased post-treatment NET density correlates with poorer response. Targeting NET formation may represent a novel therapeutic strategy to enhance NACI efficacy in LAGC.
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