Shah, M.D. Ajani, M.D., of the University of Texas M. D. Anderson Cancer Center, Houston, comment on the findings of the scholarly studies on gastric cancer. Regarding the analysis by Anderson and colleagues, ‘These findings have essential implications. The distinction between cardia and noncardia gastric cancer is relevant to the part of H pylori carcinogenesis. The pathogenesis of noncardia cancers follows a multistep progression that’s likely initiated by persistent inflammation. The condition progresses through persistent gastritis [irritation of the liner of the abdomen], intestinal metaplasia, and dysplasia [abnormal cells].’ Drs. Shah and Ajani talk to if the huge sample size of the GASTRIC meta-analysis can overcome heterogeneity in biology, therapy, or both.Based on a novel mechanism for inducing immunologic tolerance, we chose low-dosage radiation plus sirolimus . Unlike calcineurin inhibitors such as cyclosporine, sirolimus does not block the procedure of T-cell activation through the T-cell receptor but instead inhibits T-cell proliferation by binding to the mammalian focus on of rapamycin. Activated T cells that cannot proliferate become anergic, which property can promote T-cell tolerance.10 We demonstrated the feasibility of the approach in a murine model where we administered a short span of either cyclosporine or sirolimus after a single dose of total-body system irradiation .