Immunology Department, Marqués de Valdecilla Hospital-IDIBAL, Santander, Spain.
Department of Health and Nutrition Biotechnology, Asian University, Taichung, Taiwan.
Clin Chim Acta. 2016 Sep 1;460:78-87. doi: 10.1016/j.cca.2016.06.027. Epub 2016 Jun 24.
After decades of progress based on chemotherapy and targeted agents, patients with metastatic colorectal cancer still have low long-term survival, with more than 500,000 deaths occurring worldwide every year. Recent results showing clinical evidence of efficacy using immunotherapy in other types of tumors, such as melanoma and lung cancer, have also made this a viable therapy for evaluation in colorectal cancer in clinical trials. The development of cancer immunotherapies is progressing quickly, with a variety of technological approaches. This review summarizes the current status of clinical trials testing immunotherapy in colorectal cancer and discusses what has been learned based on previous results. Immunotherapy strategies, such as various models of vaccines, effector-cell therapy and checkpoint inhibitor antibodies, provide protection against progression for a limited subset of patients diagnosed with colorectal cancer. A better understanding of particular immune cell types and pathways in each patient is still needed. These findings will enable the development of novel biomarkers to select the appropriate subset of patients to be treated with a particular immunotherapy, and the tendencies determined from recent results can guide clinical practice for oncologists in this new therapeutic area and in the design of the next round of clinical trials.
经过几十年基于化疗和靶向药物的进展，转移性结直肠癌患者的长期生存率仍然较低，全世界每年有超过 50 万人因此死亡。最近的研究结果表明，免疫疗法在其他类型的肿瘤（如黑色素瘤和肺癌）中具有临床疗效，这也使得免疫疗法成为临床试验中评估结直肠癌的一种可行疗法。癌症免疫疗法的发展迅速，采用了多种技术方法。本文总结了目前正在临床试验中测试免疫疗法治疗结直肠癌的现状，并根据以往的结果讨论了从中获得的经验。免疫疗法策略，如各种疫苗模型、效应细胞疗法和检查点抑制剂抗体，为有限的一部分诊断为结直肠癌的患者提供了阻止疾病进展的保护。仍需要更好地了解每位患者中特定免疫细胞类型和途径。这些发现将有助于开发新的生物标志物来选择特定免疫疗法的合适患者亚群，并且从最近的结果中确定的趋势可以为肿瘤学家在这一新的治疗领域的临床实践以及下一轮临床试验的设计提供指导。
