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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
Summary
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.
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