Obermannova R
Klin Onkol. 2017 Winter;30(Supplementum3):50-54.
Chemotherapy prolongs overall survival (OS) in esophageal (EC) and gastric cancer (GC). Unsatisfactory results of systemic therapy initiated a search for new treatment options. In metastatic disease, a number of targeted drugs were tested; however, several phase III studies assessing receptor tyrosin kinase-related signaling pathways, such as EGFR, MET/HGF or mTOR, failed. Trastuzumab remains the only targeted drug with a known molecular predictor, which extended the OS in metastatic gastric adenocarcinoma and adenocarcinoma of esophago-gastric junction. In the past two years, The Cancer Genome Atlas group published an analysis based on the genomic characteristics of GC and EC. Therefore, a better understanding of tumor biology may be a way towards stratification of treatment based on genetic and molecular characteristics and not merely on anatomical or histological basis. The rapid development in research of anti-tumor immunity and an achievement in the field of checkpoint inhibitors use in malignant melanoma have also enabled research in other cancers, including gastrointestinal malignancies. Checkpoints are part of a comprehensive and complex process of the immune system, and at the same time, the key points in the emergence of tumor tolerance. Their activation protects the organism against autoimmune reactions, but at the same time allows induction of tumor tolerance. Discussing checkpoints include the cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed death-1 (PD-1) receptors and the ligand PD-1 receptor, programmed death ligand-1 (PD-L1). In this article, I summarize current findings on the use of anti PD1 agents in EC and GC.Key words: esophageal cancer - stomach cancer - checkpoint inhibitors This work was supported by the project of Ministry of Health of the Czech Republic No. 15 P03- 17-29389A and by projects LO1413, DRO and LM15089 BBMRI-CZ. The author declares she has no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 17. 9. 2017Accepted: 5. 11. 2017.
化疗可延长食管癌（EC）和胃癌（GC）患者的总生存期（OS）。全身治疗效果不尽人意促使人们寻找新的治疗方案。在转移性疾病中，多种靶向药物进行了试验；然而，多项评估受体酪氨酸激酶相关信号通路（如表皮生长因子受体（EGFR）、间质-上皮转化因子/肝细胞生长因子（MET/HGF）或哺乳动物雷帕霉素靶蛋白（mTOR））的Ⅲ期研究均失败了。曲妥珠单抗仍是唯一一种具有已知分子预测指标的靶向药物，它可延长转移性胃腺癌和食管胃交界腺癌患者的总生存期。在过去两年中，癌症基因组图谱研究小组发表了一项基于胃癌和食管癌基因组特征的分析。因此，更好地了解肿瘤生物学特性可能是实现基于基因和分子特征而非单纯解剖学或组织学特征进行治疗分层的途径。抗肿瘤免疫研究的快速发展以及恶性黑色素瘤中检查点抑制剂应用领域所取得的成果，也推动了包括胃肠道恶性肿瘤在内的其他癌症的研究。检查点是免疫系统全面而复杂过程的一部分，同时也是肿瘤免疫逃逸的关键点。其激活可保护机体免受自身免疫反应，但同时也会诱导肿瘤免疫逃逸。所讨论的检查点包括细胞毒性T淋巴细胞相关抗原4（CTLA-4）、程序性死亡蛋白1（PD-1）受体以及PD-1受体的配体程序性死亡配体1（PD-L1）。在本文中，我总结了抗PD1药物在食管癌和胃癌中应用的当前研究结果。关键词：食管癌 - 胃癌 - 检查点抑制剂 本研究得到了捷克共和国卫生部项目No. 15 P03 - 17 - 29389A以及项目LO1413、DRO和LM15089 BBMRI - CZ的支持。作者声明在研究中使用的药物、产品或服务方面不存在潜在利益冲突。编辑委员会声明该手稿符合国际医学期刊编辑委员会（ICMJE）对生物医学论文的推荐要求。提交日期：2017年9月17日 接受日期：2017年11月5日
