[化学疗法在晚期食道癌的历史和前景]
1Dept. of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital.
Gan to kagaku ryoho. Cancer & chemotherapy
|March 18, 2024
概括
免疫检查点抑制剂改善了晚期食道癌的存活率,成为新的护理标准. 目前正在进行的研究正在探索新的组合,以进一步提高这种具有挑战性的疾病的治疗结果.
科学领域:
- 在瘤学瘤学.
- 胃肠道瘤学 胃肠道瘤学
- 癌症治疗方法 癌症治疗方法
背景情况:
- 历史上,晚期食道癌的预后很差,治疗选择有限.
- 化疗方案,如西斯普拉丁加5-FU (CF) 和税是标准的,但缺乏强大的随机对照试验 (RCT) 数据.
- 包括抗EGFR抑制剂在内的向疗法未能在食道癌症中显示出显著的生存益处.
研究的目的:
- 审查晚期或复发的食道癌的化疗的演变.
- 讨论免疫检查点抑制剂在食道癌症治疗中的影响和未来方向.
- 突出食道癌治疗的最新进展和正在进行的研究.
主要方法:
- 对评估免疫检查点抑制剂的关键临床试验 (KEYNOTE-181,ATTRACTION-3,KEYNOTE-590,CheckMate 648) 的综述.
- 分析数据,比较单剂免疫检查点抑制剂和与化疗联合治疗的数据.
- 化学疗法的历史概述和针对性治疗在晚期食道癌中的疗效.
主要成果:
- 与化疗相比,单剂免疫检查点抑制剂 (pembrolizumab,nivolumab) 在特定情况下延长了生存期.
- 在一线治疗中,组合疗法 (pembrolizumab + CF,nivolumab + CF,nivolumab + ipilimumab) 在单独治疗CF方面表现出优越性.
- 这些组合现在被认为是治疗先进食道癌的第一线治疗的标准护理.
结论:
- 免疫检查点抑制剂在治疗晚期食道癌方面取得了重大进展,改善了生存率.
- 尽管取得了进展,但目前的结果仍然不令人满意,需要进一步研究新的治疗策略.
- 未来的研究重点是将免疫检查点抑制剂与化疗结合起来,并探索新的药物来克服治疗耐药性.
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