转移性胃癌的免疫疗法
Chang-Fei Li1, Li-Li Lian2, Qiu-Ru Li2
1Department of Patient Service Center, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China.
World journal of gastrointestinal surgery
|December 9, 2024
概括
编程细胞死亡1联体1 (PD-L1) 是胃癌中免疫检查点抑制剂 (ICI) 治疗反应的生物标志物. 然而,并非所有PD-L1阳性患者都受益,因此需要更好的生物标志物来准确治疗.
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:
- 编程细胞死亡1联体1 (PD-L1) 表达是免疫检查点抑制剂 (ICI) 治疗反应的泛癌生物标志物.
- 四种分子亚型用于胃癌 (GC) 预后,诊断和治疗指导.
- 使用Nivolumab,Pembrolizumab和Avelumab等ICI治疗转移性GC (mGC) 的临床试验已经显示出不同的疗效.
研究的目的:
- 评估PD-L1作为ICI治疗反应的泛癌生物标志物的作用.
- 讨论单剂ICI和组合治疗在mGC中的疗效.
- 突出了改善生物标志物的迫切需要,以便在GC中进行精确的ICI治疗.
主要方法:
- 对临床试验和关于PD-L1表达和ICI疗效在GC中的文献的审查.
- 对接受ICI,单独或与化疗一起的转移性GC患者的治疗结果的分析.
- 讨论PD-L1作为唯一预测生物标志物的局限性.
主要成果:
- PD-L1表达是ICI反应的公认生物标志物.
- 结合ICI和化疗为mGC患者提供了生存益处和手术机会.
- 并非所有PD-L1阳性患者都对ICI治疗有反应,这表明PD-L1的限制是唯一的预测因素.
结论:
- 虽然PD-L1是一种有价值的生物标志物,但其对GCICI反应的预测能力是不完整的.
- 组合疗法 (ICI + 化疗) 改善了mGC的结果.
- 新型生物标志物的开发对于优化ICI治疗策略和GC患者选择至关重要.
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