CD274 and neoplasm: Although circulating tumor cell (CTC) counts increased in both groups after treatment, the post-treatment count and the magnitude of increase were significantly greater in the CIH group (P<0.001), potentially indicating enhanced therapy-induced immune activation and tumor cell death.<h4>Conclusion</h4>The addition of hyperthermia to PD-1 inhibitor and chemotherapy significantly improves PFS and reduces specific adverse events in patients with PD-L1 CPS-negative advanced GC.