针对局部高级结肠癌的术前策略
Kanika G Nair1, Suneel D Kamath1, Nivan Chowattukunnel1
1Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Center, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Current treatment options in oncology
|February 13, 2024
概括
新辅助化疗和免疫疗法对于局部晚期结肠癌 (LACC) 是安全有效的. 早期的MMR状态测试对于选择最佳的新辅助疗法至关重要,特别是对于dMMR LACC,以改善患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 胃肠道瘤学 胃肠道瘤学
- 新辅助疗法是一种新辅助疗法.
背景情况:
- 局部晚期结肠癌 (LACC) 在治疗选择方面存在挑战.
- 目前的分期方法,如CT扫描,可能会导致过度分期,影响新辅助疗法决策.
- 不匹配修复 (MMR) 状态是预测对新辅助疗法反应的关键因素.
研究的目的:
- 评估新辅助化疗和免疫疗法对LACC的安全性和有效性.
- 强调早期MMR状态测试对于个性化新辅助治疗选择的重要性.
- 解决有关LACC中CT分期精度及其对治疗计划的影响的担忧.
主要方法:
- 对FOxTROT试验和其他关于LACC新辅助疗法的相关研究结果的审查.
- 对dMMR和pMMRLACC患者治疗新辅助化疗和免疫治疗的病理反应率的分析.
- 讨论用于准确分期的成像标准和为新辅助干预措施选择患者.
主要成果:
- 新辅助化疗是安全的,可以减少cT3-4 LACC的残留/复发性癌症.
- 新辅助免疫疗法在dMMR LACC中显示出戏剧性的病理反应,在pMMR LACC中显示出潜在的病理反应.
- 对恶性节点需要准确的CT标准,以减少过度阶段化和改善新辅助疗法的吸收.
结论:
- 包括化疗和免疫疗法在内的新辅助疗法是LACC的可行的策略.
- 早期确定MMR状态对于定制新辅助治疗至关重要,特别是避免dMMRLACC中的化疗.
- 多学科方法和改进的成像解释对于优化LACC中新辅助治疗选择和结果至关重要.
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