免疫检查点抑制在先进的结直肠癌与遗传和获得的微卫星不稳定性:当前状态和未来的方向
Constantin A Dasanu1,2, Mohammed Alani3, Shaghayegh Habibi3
1Lucy Curci Cancer Center, Eisenhower Health, Rancho Mirage, CA, USA.
概括
患有微卫星不稳定性 (MSI) 的晚期结肠直肠癌患者有前途的治疗选择. 免疫检查点抑制剂 (ICI) 疗法,包括单剂和组合疗法,显示出显著的疗效,并正在扩大治疗领域.
科学领域:
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
- 免疫治疗是一种免疫疗法.
背景情况:
- 结肠直肠癌 (CRC) 管理正在发展,特别是对于晚期的结肠直肠癌.
- 微卫星不稳定性 (MSI) 是CRC的关键生物标志物,影响治疗反应.
- 免疫检查点抑制剂 (ICI) 已经成为一种重要的治疗类.
研究的目的:
- 综合审查目前关于单剂和组合疗法的数据,用于MSI的晚期结直肠癌.
- 评估免疫检查点抑制剂 (ICI) 对遗传性和获得性MSI患者的疗效.
- 探索生物标志物在预测ICI治疗反应中的作用.
主要方法:
- 在PubMed和MEDLINE数据库的系统文献搜索 (开始至2022年12月).
- 包括来自独立来源的数据:美国食品和药物管理局和clinicaltrials.gov.gov.
- 分析评估微卫星稳定性测试,瘤突变负担 (TMB) 和生殖系突变分析的研究.
主要成果:
- 微卫星稳定性测试,TMB和生殖线分析确定了受益于ICI治疗的患者.
- 单剂 pembrolizumab 在高MSI患者中表现出优于传统化疗的优势.
- 尼沃卢马布-伊皮利穆马布是一种已批准的ICI组合疗法;德托拉利马布在耐火性dMMR癌症中显示出前景.
结论:
- 患有MSI的晚期结直肠癌的治疗前景是乐观的.
- 新型和有效的ICI药物和组合正在扩大治疗选择.
- 需要进一步研究生物标志物和最佳ICI治疗持续时间.
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