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在pMMR/MSS局部晚期直肠癌中结合新辅助化学放射治疗的研究进展

Yang He¹, Wendong Gu¹, Yingjie Shao¹

¹Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China.

Frontiers in immunology

|August 27, 2025

概括

局部晚期直肠癌 (LARC) 具有熟练的不匹配修复 (pMMR) /微卫星稳定 (MSS) 状态显示对免疫检查点抑制剂 (ICI) 的耐药性. 本综述探讨了改善pMMR/MSS LARC中的ICI和新辅助化疗 (nCRT) 组合的挑战和潜在生物标志物.

科学领域:

癌症学
免疫疗法
分子生物学

背景情况:

局部晚期直肠癌 (LARC) 治疗传统上使用新辅助化疗 (nCRT),改善局部控制,但不能改善长期存活.
熟练的不匹配修复 (pMMR) /微卫星稳定 (MSS) LARC对当前的免疫治疗策略具有抗性,包括免疫检查点抑制剂 (ICI).

研究的目的:

审查pMMR/MSS LARC的分子特征和治疗挑战.
阐明ICI机制及其与nCRT的潜在协同作用.
在pMMR/MSS LARC中评估患者选择和治疗疗效的新兴生物标志物.

主要方法:

对pMMR/MSS LARC分子特征的文献综述
免疫检查点抑制剂 (ICI) 途径及其与新辅助化疗 (nCRT) 相互作用的分析.
最近临床试验进展和生物标志物的实用性

主要成果:

pMMR/MSS LARC具有独特的分子格局,有助于免疫疗法抵抗.
结合ICI和nCRT的策略有希望,但需要小心选择患者.
新出现的生物标志物可能有助于识别可能受益于这些新型治疗方法的患者.

结论:

在pMMR/MSS LARC中解决免疫疗法耐药性对于改善患者的结果至关重要.
进一步研究协同作用组合和预测生物标志物至关重要.
个性化治疗策略有望提高这种具有挑战性的LARC亚型的疗效.

关键词:

一个MSS 组合治疗免疫检查点抑制剂局部发达的直肠癌新辅助化学放射治疗

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