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Dissecting genetic and immune drivers of heterogeneous responses to neoadjuvant immunochemotherapy in gastric cancer - PubMed

2 days ago
  • #multi-omics
  • #immunochemotherapy
  • #gastric cancer
  • Neoadjuvant immunochemotherapy (nICT) improves gastric cancer (GC) outcomes, but resistance remains a challenge.
  • Study analyzes 110 GC patients from NEOSUMMIT-01 trial using multi-omic sequencing and functional validation.
  • Identifies five tumor microenvironment ecotypes (EC1-5) linked to therapy response.
  • nICT achieves response in EC1 (T cell activation), EC2 (tertiary lymphoid structures), and EC3 (vascular normalization).
  • nICT resistance observed in EC4 (extracellular matrix organization) and EC5 (immunosuppressive macrophage enrichment).
  • Resistance in EC5 mediated by interaction between APOA1+ tumor cells and TREM2+ macrophages.
  • Multiple biomarkers associated with nICT efficacy identified, including SBS19, HLA-B��15:02, FDXR expression, and FGFR pathway activity.
  • Provides a multi-omic stratification model for treatment response-based patient stratification.
  • Study offers mechanistic insights into nICT in GC, informs therapeutic decisions, and reveals potential targets.