结直肠癌的外科手术期间免疫检查点抑制:最近的进展和未来的方向
Jiao-Ting Chen1, Yu-Wen Zhou1, Ting-Rui Han2
1Department of Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Frontiers in immunology
|November 29, 2023
概括
术后免疫疗法对结肠直肠癌 (CRC) 患者有希望,改善了那些微卫星高度不稳定/缺陷不匹配修复 (MSI-H/dMMR) 患者的治疗结果,甚至有些人患有不匹配修复能力/微卫星稳定 (pMMR/MSS) 疾病.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 胃肠道手术 胃肠道手术
背景情况:
- 手术切除对于结肠直肠癌至关重要,但对于晚期或转移性病例并不总是可行或完全有效.
- 周围手术治疗可以降低瘤的发展阶段,并减少CRC的复发/转移.
- 免疫检查点抑制剂 (ICI) 在MSI-H/dMMRCRC中有效,但在pMMR/MSSCRC中效果较差,尽管存在例外.
研究的目的:
- 审查各种免疫疗法组合在术后CRC治疗中的疗效和安全性.
- 探索基于免疫治疗的术后CRC疗法患者选择的预测因素.
- 突出 CRC 中术后免疫治疗的未来研究方向.
主要方法:
- 在CRC中进行术后免疫治疗临床试验的综合文献综述.
- 从涉及免疫疗法组合的试验中分析疗效和安全数据.
- 综合当前关于CRC外科设置中的免疫治疗的研究.
主要成果:
- 在MSI-H/dMMR CRC中,ICI提供了显著的生存益处和安全性.
- 新出现的证据表明,免疫疗法在pMMR/MSS CRC和某些dMMR/MSI-H病例中具有抗性的潜在好处.
- 越来越多地研究涉及免疫疗法,化疗和放射治疗的组合疗法.
结论:
- 对于CRC,外科期免疫疗法策略正在发展.
- 识别预测生物标志物对于优化患者选择和治疗反应至关重要.
- 需要进一步的研究来完善免疫疗法组合,并扩大其在CRC中的应用.
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