a The Royal Marsden Hospital NHS Foundation Trust , Gastro-Intestinal Cancer Research Department , London , United Kingdom.
Expert Opin Biol Ther. 2016 Oct;16(10):1197-207. doi: 10.1080/14712598.2016.1213233. Epub 2016 Jul 25.
Gastric and oesophageal cancers are a pressing global health problem with high mortality rates and poor outcomes for advanced disease. The mainstay of treatment in the palliative setting has traditionally been chemotherapy, which accrues only modest survival benefits. As with other cancer types, there is increasing interest in the use of immunotherapy approaches to improve outcomes.
This paper reviews the aetiological and genetic characteristics of oesophagogastric (OG) cancers relevant to the application of immunotherapy and outlines the historical, present-day and potential future applications of immunotherapy in their management.
The use of agents targeting the PD1 pathway have led to impressive and durable responses in a minority of OG cancer patients and it would be expected that combinatorial approaches with chemotherapy, radiotherapy and other biological agents will improve responses further. Identification of clinically robust biomarkers is crucial in refining such approaches moving forwards. The application of modern sequencing technology to the development of personalized neoantigen-based vaccines represents an exciting amalgamation of genomics and immunotherapy, with potentially important clinical implications in OG cancer.
胃癌和食管癌是一个紧迫的全球健康问题，死亡率高，晚期疾病预后差。在姑息治疗中，传统的治疗方法是化疗，其仅能带来适度的生存获益。与其他癌症类型一样，人们越来越关注免疫疗法在改善治疗效果方面的应用。
本文综述了与免疫治疗应用相关的食管胃（OG）癌症的病因学和遗传学特征，并概述了免疫治疗在其治疗中的历史、现状和潜在未来应用。
靶向 PD1 通路的药物的应用使少数 OG 癌症患者获得了令人印象深刻和持久的反应，预计与化疗、放疗和其他生物制剂的联合应用将进一步提高反应率。确定临床上可靠的生物标志物对于改进这些方法至关重要。将现代测序技术应用于个体化新抗原疫苗的开发代表了基因组学和免疫治疗的令人兴奋的结合，这在 OG 癌症中具有潜在的重要临床意义。
