Department of Medicine, Royal Marsden Hospital, London and Surrey, United Kingdom
Clin Cancer Res. 2017 Oct 15;23(20):6002-6011. doi: 10.1158/1078-0432.CCR-17-0020. Epub 2017 Jun 14.
Gastrointestinal (GI) cancers are among the most deadly malignancies. Although serial incremental survival benefits have been made with cytotoxic chemotherapy with metastatic disease, a plateau of achievement has been reached. Applying modern integrative genomic technology, distinct molecular subgroups have been identified in GI cancers. This not only highlighted the heterogeneity in tumors of each primary anatomical site but also identified novel therapeutic targets in distinct molecular subgroups and might improve the yield of clinical success. Molecular characteristics of tumors and their interaction with the tumor microenvironment would further affect development of combination therapy, including immunotherapy. Currently, immune checkpoint blockade attracts the most intense research, and the successful integration of these novel agents in GI cancers in the treatment paradigm requires an in-depth understanding of the diverse immune environment of these cancers. .
胃肠道（GI）癌症是最致命的恶性肿瘤之一。尽管转移性疾病的细胞毒性化疗带来了连续的生存获益，但已经达到了一个成就的高原。应用现代综合基因组技术，已经在 GI 癌症中确定了不同的分子亚群。这不仅突出了每个主要解剖部位肿瘤的异质性，而且在不同的分子亚群中确定了新的治疗靶点，并可能提高临床成功的效果。肿瘤的分子特征及其与肿瘤微环境的相互作用将进一步影响联合治疗的发展，包括免疫治疗。目前，免疫检查点阻断吸引了最强烈的研究，这些新型药物在胃肠道癌症治疗模式中的成功整合需要深入了解这些癌症多样化的免疫环境。
