Higher TIGIT expression in the intraperitoneal immune microenvironment is associated with shorter progression-free survival in patients with gastric cancer with peritoneal metastasis treated with intraperitoneal paclitaxel.

Authors

Atsushi Yamada, Motohiro Imano, Hiroaki Kato, Ryusuke Kobayashi, Naoko Kounami, Masuhiro Terada, Masashi Kohda, Tomoya Nakanishi, Yoko Hiraki, Osamu Shiraishi, Atsushi Yasuda, Masayuki Shinkai, Takushi Yasuda

Published in

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

Gastric cancer with peritoneal metastasis has a poor prognosis. This exploratory study evaluated whether immune checkpoint molecules in the intraperitoneal immune microenvironment are associated with clinical outcomes during intraperitoneal paclitaxel (ipPTX)-based combination chemotherapy.
Twenty-nine previously untreated patients with gastric cancer and macroscopic peritoneal metastasis who underwent staging laparoscopy and received ipPTX-based combination chemotherapy were retrospectively analyzed. Lymphocyte subsets in peritoneal lavage fluid were evaluated by flow cytometry. TIGIT, TIM-3, and LAG-3 expression was assessed in cell block specimens prepared from peritoneal lavage fluid by immunohistochemistry. Biomarker analyses were exploratory. Immune-related markers were analyzed primarily as continuous variables, and multivariable progression-free survival (PFS) and overall survival (OS) models were restricted to TIGIT and baseline Peritoneal Carcinomatosis Index (PCI) using Firth's penalized Cox regression.
Median PFS and OS were 10.6 and 17.2 months, respectively. Among 27 patients evaluable for TIGIT, higher TIGIT expression was associated with shorter PFS in a continuous-variable Cox model (hazard ratio [HR] per 10-percentage-point increase, 1.53; 95% confidence interval [CI] 1.12-2.08; p = 0.008). After adjustment for baseline PCI, the association remained (HR, 1.48; 95% CI 1.04-2.10; p =0.030). TIM-3 did not show a clear association with survival outcomes.
Higher TIGIT expression in the intraperitoneal immune microenvironment was associated with shorter PFS in this small exploratory cohort receiving ipPTX-based combination chemotherapy.

PMID:
42886417
Bibliographic data and abstract were imported from PubMed on 17 Oct 2026.

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