免疫疗法时代的pMMR/MSS局部晚期直肠癌的新辅助疗法:当前的景观和未来的前景
Benish Farooq1, Xingyu Li2, Sa Xiao3
1School of Life Sciences, Lanzhou University, Lanzhou, China.
Frontiers in oncology
|December 19, 2025
概括
新辅助性化疗与免疫疗法显著提高了直肠癌的反应率,使更多患者能够保存器官. 需要进一步的研究来优化治疗并确认长期益处.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫治疗是一种免疫疗法.
背景情况:
- 术后的新辅助化疗放射治疗 (NCRT) 是直肠癌的标准治疗方法.
- 传统的NCRT产生了有限的病理完整响应 (pCR) 率 (15-20%).
- 与NCRT结合的免疫疗法在早期临床研究中显示出有希望的结果.
研究的目的:
- 审查基于免疫治疗的NCRT (iNCRT) 在熟练的不匹配修复/微卫星稳定性 (pMMR/MSS) 的疗效和挑战.
- 探索INCRT在器官保存方面的潜力.
- 确定未得到满足的需求和未来的研究方向.
主要方法:
- 临床研究和III期随机对照试验 (RCT) 的综合文献综述.
- 用 iNCRT 对抗常规NCRT 的响应率 (pCR,临床完整响应 (cCR)) 的分析.
- 讨论包括生物标志物识别,治疗优化和反应评估在内的挑战.
主要成果:
- iNCRT的pCR/cCR比率达到30-60%,远高于传统的NCRT.
- 增加的响应率有助于获得Watch-and-Wait (WW) 策略的资格,促进器官的保存.
- 目前正在进行多项III期RCT,以进一步验证这些发现.
结论:
- iNCRT提供了一种有希望的方法来克服pMMR/MSS直肠癌中的治疗耐药性.
- 关键的挑战包括识别预测生物标志物,优化治疗方案,克服评估复杂性.
- 进一步的研究是必不可少的,以确认长期生存益处,并完善INCRT,以最大限度地保存器官.
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