Jindal Vishal
Department of Internal Medicine, St. Vincent Hospital, Worcester, MA, USA.
J Gastrointest Oncol. 2018 Apr;9(2):390-403. doi: 10.21037/jgo.2018.01.03.
Gastrointestinal (GIT) tumors are extremely fatal and lethal tumors with limited therapeutic options. Antitumor immunity is new line of research in management of solid tumors. Immune check points are negative regulators of immune system and control the immune response. These checkpoints are exploited by cancer cells. Cancer cells causes early activation of checkpoints and suppress the immune response, and therefore have unchecked growth and metastasis of malignant cells. Immune checkpoint inhibitors (ICIs), downregulates these checkpoints and activate the proliferation of cytotoxic T cells which helps in lysis of tumor cells. ICIs have shown the promising results in management of melanoma, non-small cell lung cancer and renal cell carcinoma. Encouraged by their recent success in solid tumors many clinical trials are ongoing to evaluate their efficacy in GIT tumors. In this article we will try to explain rationale for use of ICIs in GIT tumors. We will summarize the ongoing research, preliminary results and future aspects of ICIs in GIT malignancies.
胃肠道(GIT)肿瘤是极具致命性的肿瘤,治疗选择有限。抗肿瘤免疫是实体瘤治疗的新研究方向。免疫检查点是免疫系统的负调节因子,控制免疫反应。癌细胞利用这些检查点。癌细胞会导致检查点的早期激活并抑制免疫反应,从而使恶性细胞不受控制地生长和转移。免疫检查点抑制剂(ICIs)下调这些检查点并激活细胞毒性T细胞的增殖,这有助于肿瘤细胞的裂解。ICIs在黑色素瘤、非小细胞肺癌和肾细胞癌的治疗中已显示出有前景的结果。受其近期在实体瘤治疗中取得成功的鼓舞,许多临床试验正在进行,以评估其在GIT肿瘤中的疗效。在本文中,我们将试图解释在GIT肿瘤中使用ICIs的原理。我们将总结ICIs在GIT恶性肿瘤中的正在进行的研究、初步结果和未来展望。