Basile Debora, Garattini Silvio Ken, Bonotto Marta, Ongaro Elena, Casagrande Mariaelena, Cattaneo Monica, Fanotto Valentina, De Carlo Elisa, Loupakis Fotios, Urbano Federica, Negri Francesca V, Pella Nicoletta, Russano Marco, Brunetti Oronzo, Scartozzi Mario, Santini Daniele, Silvestris Nicola, Casadei Gardini Andrea, Puzzoni Marco, Calvetti Lorenzo, Cardarelli Nadia, Aprile Giuseppe
a Department of Oncology , University and General Hospital , Udine , Italy.
c Medical Oncology 1, Department of Medical and Experimental Oncology , IOV - IRCCS , Padova , Italy.
Expert Opin Biol Ther. 2017 Jun;17(6):709-721. doi: 10.1080/14712598.2017.1315405. Epub 2017 Apr 13.
In the last few years, significant advances in molecular biology have provided new therapeutic options for colorectal cancer (CRC). The development of new drugs that target the immune response to cancer cells seems very promising and has already been established for other tumor types. In particular, the use of immune checkpoint inhibitors seems to be an encouraging immunotherapeutic strategy. Areas covered: In this review, the authors provide an update of the current evidence related to this topic, though most immunotherapies are still in early-phase clinical trials for CRC. To understand the key role of immunotherapy in CRC, the authors discuss the delicate balance between immune-stimulating and immune-suppressive networks that occur in the tumor microenvironment. Expert opinion: Modulation of the immune system through checkpoint inhibition is an emerging approach in CRC therapy. Nevertheless, selection criteria that could enable the identification of patients who may benefit from these agents are necessary. Furthermore, potential prognostic and predictive immune biomarkers based on immune and molecular classifications have been proposed. As expected, additional studies are required to develop biomarkers, effective therapeutic strategies and novel combinations to overcome immune escape resistance and enhance effector response.
在过去几年中，分子生物学取得了重大进展，为结直肠癌（CRC）提供了新的治疗选择。开发针对癌细胞免疫反应的新药似乎非常有前景，并且已经在其他肿瘤类型中得到应用。特别是，免疫检查点抑制剂的使用似乎是一种令人鼓舞的免疫治疗策略。涵盖领域：在本综述中，作者提供了与该主题相关的当前证据的最新情况，尽管大多数免疫疗法仍处于结直肠癌的早期临床试验阶段。为了理解免疫疗法在结直肠癌中的关键作用，作者讨论了肿瘤微环境中发生的免疫刺激和免疫抑制网络之间的微妙平衡。专家意见：通过检查点抑制调节免疫系统是结直肠癌治疗中一种新兴的方法。然而，需要能够识别可能从这些药物中获益的患者的选择标准。此外，基于免疫和分子分类的潜在预后和预测性免疫生物标志物已经被提出。不出所料，需要更多的研究来开发生物标志物、有效的治疗策略和新的联合疗法，以克服免疫逃逸抗性并增强效应器反应。
