在瘤学中进行手术前免疫治疗
Deutsches Arzteblatt international
|November 20, 2025
概括
新辅助性免疫检查点抑制剂 (ICI) 改善了乳腺癌,肺癌和食管胃癌的存活率. 对于直肠癌,ICI治疗可以导致完全缓解,可能避免手术.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 手术瘤学手术瘤学
背景情况:
- 免疫检查点抑制剂 (ICI) 是已确立的转移性癌症治疗方法.
- 术前 (新辅助剂) ICI的使用越来越多地被研究以改善生存结果.
- 研究重点是ICI在手术前的各种固体瘤中的疗效.
研究的目的:
- 审查新辅助免疫检查点抑制剂 (ICI) 在特定癌症中的疗效.
- 评估ICI在手术前对无事件生存 (EFS) 和整体生存 (OS) 的影响.
- 评估新辅助ICI疗法的当前批准和未来潜力.
主要方法:
- 自2018年以来发表的临床相关研究的系统审查.
- 在PubMed上集中搜索乳腺,NSCLC,结肠直肠和食道胃癌中的新辅助ICI.
- 包括国际会议摘要作为综合数据.
主要成果:
- 杜尔瓦卢马布加化学疗法是IIa+三阴性乳腺癌的标准治疗方法,改善5年EFS9%和OS5%.
- 在NSCLC (II/III阶段) 中,新辅助性ICI与化疗增加了2年的EFS~11%.
- 食管胃腺癌 (II/III阶段) 经过杜尔瓦卢马布和化疗,两年的EFS增加了8%;MSI的直肠癌显示出高完全缓解率 (50-100%),可能避免手术.
结论:
- 新辅助性ICI疗法正在成为标准或接近于某些癌症的批准.
- 与ICI相关的毒性管理需要仔细注意.
- 生物标志物识别对于预测患者反应和优化ICI使用至关重要,考虑到不良影响和成本.
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