Macropinocytosis of neutrophil extracellular trap by gastric cancer cells promotes immune escape and peritoneal metastasis

This study investigates how ascitic neutrophil extracellular traps (NETs) contribute to immune escape and peritoneal metastasis (PM) in gastric cancer (GC). The authors demonstrate that GC cells internalize NETs through macropinocytosis, which activates the cGAS-STING pathway, leading to the upregulation of immune checkpoint molecules CEACAM1 and PD-L1, thereby promoting an immunosuppressive environment. The findings suggest that targeting NETs and PD-L1 could offer a novel therapeutic strategy for improving outcomes in patients with PM.