ReviewFrontiers in oncology2026
Spatial immune ecology of immunotherapy resistance in gastric and gastroesophageal junction adenocarcinoma.
Review in Frontiers in oncology, 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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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.
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Authors and funding
3 authors.
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Abstract
Immune checkpoint inhibitors now occupy a central place in the management of advanced gastric and gastroesophageal junction adenocarcinoma, yet durable benefit remains uneven across patients, lesions, and metastatic sites. Conventional biomarkers, including programmed death-ligand 1 scoring, microsatellite instability or mismatch-repair deficiency, HER2, claudin 18.2, Epstein-Barr virus status, and tumor mutational burden, define important clinical and biological contexts but do not fully explain whether antitumor immunity can reach, recognize, and control malignant tissue. This narrative Review uses a spatial immune-ecology lens to interpret immunotherapy resistance through three linked tissue-level axes: immune accessibility, immune competence, and immune suppression. Within this framework, gastric and gastroesophageal junction adenocarcinoma can be organized into immune-desert, immune-excluded, inflamed-dysfunctional, tertiary lymphoid structure-rich immune-active, and metastatic-niche ecosystems, with particular emphasis on peritoneal and liver metastases. We distinguish gastric or gastric/gastroesophageal junction immune-checkpoint-inhibitor outcome-linked evidence from gastric spatial-biology or prognostic evidence, pan-cancer mechanisms, and more exploratory concepts. For now, spatial features such as tumor-nest CD8+ infiltration, tertiary lymphoid structure maturity, LAMP3+ dendritic-cell proximity, cancer-associated fibroblast-myeloid barriers, and lesion-level biomarker discordance are best regarded as complements to guideline-supported biomarkers and as pharmacodynamic endpoints, rather than independent treatment-selection tools, until they are tested prospectively in gastric and gastroesophageal junction immune-checkpoint-inhibitor outcome-linked cohorts.
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