针对可切除的局部晚期食道癌的免疫疗法
Cameron N Fick1, Elizabeth G Dunne1, Smita Sihag1
1Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
The Annals of thoracic surgery
|February 26, 2024
概括
免疫检查点抑制剂 (ICI) 在治疗晚期食道癌方面表现有前途,早期试验报告了高反应率和可接受的安全性. 进一步的III期试验正在进行中,以确认在新辅助和外科外科设置中的生存益处.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 胃肠道癌症研究研究
背景情况:
- 局部晚期食道和胃食道结 (GEJ) 癌症的标准治疗包括新辅助性化疗或外科手术后期化疗.
- 尽管目前的护理标准,这些患者的无病生存率仍然低于最佳水平.
- 免疫检查点抑制剂 (ICI) 已被批准用于辅助治疗,但它们在新辅助和外科手术期间的作用仍在调查中.
研究的目的:
- 审查当前的文献和正在进行的临床试验,以使用免疫疗法治疗局部晚期食道和GEJ癌症.
- 评估免疫检查点抑制剂在这些恶性瘤的新辅助和术后环境中的疗效和安全性.
主要方法:
- 使用PubMed在线数据库进行了文献搜索.
- 通过对ClinicalTrials.gov.gov的审查,确定了正在进行的临床试验.
主要成果:
- 辅助尼沃卢马布是唯一经批准的免疫疗法,用于在局部晚期食道癌的残留疾病后的新辅助化学放射疗法和手术.
- 早期试验显示,新辅助/术后ICI与标准护理相结合的病理完整响应率高达60%.
- 对食道状细胞癌的ICI加上化学放射治疗和对不匹配修复缺陷腺癌的双检查点抑制观察到的最高反应率;安全性概况可接受,综合不良事件率为27%.
结论:
- 目前针对可切除食道癌的免疫疗法的临床应用仅限于临床试验之外的辅助剂环境.
- 目前正在进行的III期试验调查新辅助和外科期免疫疗法对于生成生存数据至关重要.
- 这些试验的结果可能会导致局部晚期食道和GEJ癌症的治疗建议发生重大变化.
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