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Immunotherapy in Gastrointestinal Malignancies.

Jonathan Mizrahi¹, Shubham Pant²

¹Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Advances in Experimental Medicine and Biology

|April 18, 2020

Summary

This summary is machine-generated.

Immunotherapy shows limited success in most gastrointestinal (GI) cancers, despite FDA approvals for specific subsets like hepatocellular carcinoma. New strategies are crucial to expand immunotherapy benefits for patients with GI malignancies.

Keywords:

Adoptive cell therapy Anal cancer Biliary tract cancer CAR-T cells Cancer vaccine Colorectal cancer Gastric cancer Hepatocellular carcinoma Immune checkpoint inhibitor Immunotherapy Pancreatic cancer

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Flow Cytometry-Based Isolation and Therapeutic Evaluation of Tumor-Infiltrating Lymphocytes in a Mouse Model of Pancreatic Cancer

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Published on: January 17, 2025

Area of Science:

Oncology
Immunology
Gastroenterology

Background:

Gastrointestinal (GI) cancers exhibit diverse tumor immune microenvironments.
Immunotherapy, especially immune checkpoint inhibition, has shown limited efficacy in most GI malignancies compared to other solid tumors.
Current FDA-approved immunotherapies in GI cancers are restricted to specific patient subsets, such as hepatocellular carcinoma and PD-L1-positive gastric cancer.

Purpose of the Study:

To review the current landscape of immunotherapy in GI cancers.
To identify challenges and opportunities for improving immunotherapy response rates.
To highlight the need for novel therapeutic strategies and predictive biomarkers.

Main Methods:

Literature review of immunotherapy clinical trials and approvals in GI cancers.
Analysis of response rates in different GI cancer types and patient populations.
Discussion of emerging immunotherapy approaches and biomarkers.

Main Results:

Limited response to single-agent immune checkpoint inhibitors observed in most GI cancers, including colorectal, anal, biliary tract, and pancreatic cancers.
Specific approvals for anti-PD-1 therapy exist for pretreated hepatocellular carcinoma and PD-L1-positive gastric cancer.
Patients with MSI-high/dMMR tumors represent a rare exception with better response rates.

Conclusions:

The majority of GI cancer patients do not benefit from current single-agent immunotherapies.
Innovative treatment combinations, adoptive cell therapy, CAR-T cells, and novel predictive biomarkers are essential.
Advancements are needed to extend immunotherapy benefits to a broader patient population with GI malignancies.