Guo and Gao provide clinically relevant data on the systemic immune-inflammation index (SII) in patients with gastric cancer receiving immune checkpoint inhibitors (ICIs). Several aspects merit clarification before the proposed SII cutoff is interpreted for treatment selection. First, eligibility required more than two courses of immunotherapy and at least six consecutive months of follow-up. Because these criteria involve information accrued after treatment initiation, it would be important to clarify whether patients with early progression, death, or treatment discontinuation remained eligible for analysis. Second, the SII cutoff of 593.995 was selected using the Youden index and evaluated in the same cohort. Its apparent performance may therefore be optimistic, and the stability of this data-derived threshold would benefit from internal and external validation. Third, an association between SII and outcomes within an ICI-treated cohort does not establish that SII predicts differential treatment benefit from ICIs compared with alternative treatment. Clarifying these issues would better define the population represented by the findings, the robustness of the proposed cutoff, and the clinical decisions that the current evidence can support.