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Upper gastrointestinal malignancies in 2017: current perspectives and future approaches

Benjamin L Solomon1, Ignacio Garrido-Laguna1,2

  • 1Department of Internal Medicine (Division of Oncology), University of Utah School of Medicine, Salt Lake City, UT 84103, USA.

Future Oncology (London, England)
|March 16, 2018
PubMed

Insights

Immune checkpoint inhibitors like PD-1 and CTLA-4 offer long-term cancer remission. Pembrolizumab is FDA-approved for mismatch repair deficient (dMMR) cancers and advanced gastric/hepatocellular cancers.

Area of Science:

  • Oncology
  • Immunotherapy
  • Gastrointestinal Malignancies

Background:

  • Immune checkpoint inhibitors (PD-1, PD-L1, CTLA-4) have revolutionized cancer treatment, inducing durable remissions in unresectable cancers.
  • Recent advancements highlight their efficacy in gastrointestinal malignancies, particularly those with mismatch repair deficiencies (dMMR).

Purpose of the Study:

  • To review the significant breakthroughs in treating upper gastrointestinal malignancies in 2017.
  • To highlight the impact of immune checkpoint inhibitors and novel therapeutic strategies.

Main Methods:

  • Review of clinical data and FDA approvals related to immune checkpoint inhibitors.
  • Discussion of novel treatment strategies, including anti-carcinoembryonic antigen (CEA) bispecific T cells.

Main Results:

  • Pembrolizumab gained tissue-agnostic FDA approval for dMMR cancers, establishing dMMR as a predictive biomarker.
  • Pembrolizumab was also approved for PD-L1-positive advanced gastric and hepatocellular cancers.
  • Anti-CEA bispecific T cells demonstrated significant responses in microsatellite instability-low colorectal cancer.

Conclusions:

  • Immune checkpoint inhibitors represent a major advancement in treating various cancers, including gastrointestinal malignancies.
  • Biomarker-driven therapies (dMMR, PD-L1) and novel approaches like bispecific T cells are transforming outcomes for patients with upper gastrointestinal cancers.
Keywords:
immunotherapymismatch repair deficienciesupper gastrointestinal malignancies

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