Elkord Eyad, Hawkins Robert E, Stern Peter L
University of Manchester, Paterson Institute for Cancer Research, Department of Medical Oncology, Wilmslow Road, Manchester M20 4BX, UK.
Expert Opin Biol Ther. 2008 Apr;8(4):385-95. doi: 10.1517/14712598.8.4.385.
Despite improvement in conventional strategies for treating gastrointestinal (GI) carcinoma, large numbers of patients still suffer from incurable or progressive disease.
Here we consider the prospects for circumventing limitations and maximising the efficacy of different immunotherapies.
We summarise different cancer vaccines and targeted drugs and highlight the scientific rationale of using immunotherapy for targeting GI cancers, in addition to the potential strategies for improving immunotherapeutic efficacy.
RESULTS/CONCLUSION: Many cancer vaccines and antibody-directed therapies have been tested in early phase clinical trials and demonstrated proof of concept and safety. As yet few have been properly evaluated for clinical efficacy; although adoptive transfer of tumour-associated-antigen-specific T cells has shown dramatic clinical responses in some patients. The recognition of a role for T regulatory cells in limiting anti-tumour immunity has provided momentum for developing strategies to over-ride such immunoinhibitory effects. There is some evidence that conventional therapies may work by influencing these negative factors and allowing expression of immune control mechanisms. An important developing area for clinical evaluation is the testing of combined conventional and immunotherapeutic modalities which may provide for synergy; thereby circumventing the limitations of individualised treatments and generating additional clinical benefits.
尽管胃肠道（GI）癌的传统治疗策略有所改进，但仍有大量患者患有无法治愈或进展性疾病。
在此，我们探讨克服局限性并最大化不同免疫疗法疗效的前景。
我们总结了不同的癌症疫苗和靶向药物，并强调了使用免疫疗法治疗胃肠道癌症的科学原理，以及提高免疫治疗疗效的潜在策略。
结果/结论：许多癌症疫苗和抗体导向疗法已在早期临床试验中进行了测试，并证明了概念验证和安全性。然而，很少有疗法经过临床疗效的适当评估；尽管肿瘤相关抗原特异性T细胞的过继转移在一些患者中显示出显著的临床反应。T调节细胞在限制抗肿瘤免疫中的作用已得到认可，这为开发克服这种免疫抑制作用的策略提供了动力。有证据表明，传统疗法可能通过影响这些负面因素并使免疫控制机制得以表达而起作用。临床评估的一个重要发展领域是测试联合传统疗法和免疫疗法的模式，这可能会产生协同作用；从而克服个体化治疗的局限性并产生额外的临床益处。
