ArticleTherapeutic advances in gastroenterology2026
Efficacy of immune checkpoint inhibitor plus chemotherapy in ARID1A-mutated advanced gastric cancer.
Article in Therapeutic advances in gastroenterology, 2026. 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
Background: ARID1A mutations are frequent in gastric cancer (GC) and may indicate an immune-active tumor microenvironment. Objectives: This study aimed to assess the efficacy of the immune checkpoint inhibitor (ICI) plus chemotherapy as first-line therapy in advanced GC and explore its association with key molecular features according to the status of ARID1A-mutation. Design: This was a retrospective, single-center cohort study. Methods: We analyzed 258 patients with advanced HER2-negative GC who received ICI plus chemotherapy between 2022 and 2024. ARID1A mutation status and other molecular features were assessed using next-generation sequencing. Also, the status for Epstein-Barr virus (EBV), programmed death-ligand 1 (PD-L1), and claudin 18.2 was done. Treatment outcomes were evaluated between ARID1A-mutant and wild-type groups. Results: Among 258 patients, 67 (26.0%) harbored at least one ARID1A mutation. ARID1A mutant tumors (MT) showed significantly higher tumor mutational burden (median 18.0 vs 6.7 mut/Mb), EBV positivity (11.8% vs 0.6%), MSI-H status (10.6% vs 6.3%), and PD-L1 CPS ⩾50 (14.9% vs 1.0%) compared to wild-type (WT). The median progression-free survival (PFS) was numerically longer in the ARID1A MT group (9.7 vs 8.5 months; HR 0.75; 95% CI, 0.53-1.10), though not statistically significant. There was no significant difference for the ORR (55.2% vs 64.4%, Conclusion: ARID1A mutations were associated with immune-active molecular features and a trend toward improved PFS to ICI plus chemotherapy. Further research for ARID1A as a potential biomarker for ICI is warranted in advanced GC.
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