微卫星不稳定性高 (MSI-H) 胃食道腺癌的管理
Katherine I Zhou1, Brent A Hanks1,2, John H Strickler3
1Division of Medical Oncology, Department of Medicine, Duke University, Durham, NC, USA.
Journal of gastrointestinal cancer
|December 22, 2023
概括
微卫星不稳定性高 (MSI-H) 的胃食道癌对化疗有耐药性,但对免疫检查点抑制剂 (ICI) 有良好的反应. 本综述强调了MSI-H胃食道腺癌的不断变化的治疗环境.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫治疗是一种免疫疗法.
背景情况:
- 胃食道癌是全球癌症死亡的主要原因之一.
- 目前的治疗方法主要依赖于细胞毒性化疗.
- 大约4-24%的胃食道癌症表现出微卫星不稳定性高 (MSI-H) 状态.
研究的目的:
- 审查MSI-H胃食道腺癌的患病率,特征,预后和治疗.
- 专注于改变MSI-H胃食道癌症治疗的最新研究.
- 讨论管理可切除和晚期MSI-H疾病的挑战,包括对免疫检查点抑制剂 (ICI) 治疗的生物标志物需求.
主要方法:
- 最近和正在进行的研究的文献综述.
- 对MSI-H胃食道癌症免疫检查点抑制剂的临床试验数据的分析.
- 对MSI-H胃食道腺癌的预后和预测因素的讨论.
主要成果:
- MSI-H亚型与更好的预后和耐化疗性有关.
- 胃食道癌的MSI-H表现出对免疫检查点抑制剂 (ICI) 的敏感性.
- 最近的研究表明,ICI具有有前途的活性,改变了MSI-H胃食道腺癌的治疗模式.
结论:
- 免疫检查点抑制剂在治疗MSI-H胃食道腺癌方面取得了重大进展.
- 需要进行进一步的研究,以确定可切除和先进的MSI-H胃食道癌症中ICI反应的最佳生物标志物.
- MSI-H胃食道癌的管理正在转向基于免疫疗法的策略.
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