a Division of Cancer Medicine , Peter MacCallum Cancer Centre , Melbourne , Australia.
b Medical Oncology , Royal Melbourne Hospital , Melbourne , Victoria , Australia.
Expert Rev Anticancer Ther. 2018 Jul;18(7):611-618. doi: 10.1080/14737140.2018.1480942. Epub 2018 Jun 11.
Despite a variety of therapies for advanced metastatic colorectal cancer being available, the outcomes in this malignancy remain suboptimal. Immunotherapy has been slow to impact the management of this patient group. Checkpoint inhibitors, such as nivolumab, have had disappointing results when used broadly. However, for the subset of patients with microsatellite unstable colorectal cancer, the use of checkpoint inhibitors such as nivolumab appears to be transformative, and will provide a new therapeutic option for patient with advanced disease. Areas covered: Nivolumab gained regulatory approval for the treatment of dMMR/MSI-H metastatic colorectal cancer in mid 2017. The current review will summarize the clinical evidence of checkpoint inhibitors in metastatic colorectal cancer, with a focus on nivolumab. Expert commentary: For patients with dMMR/MSI-H mCRC, the use of nivolumab has now been shown to have objective and sustained clinical responses in a pivotal phase II trial. While additional data are limited, the therapeutic role for augmenting an immune response in metastatic colorectal cancer is likely to continue to expand. Further combination trials of nivolumab with immunologic and non-immunologic agents are ongoing.
尽管有多种疗法可用于治疗晚期转移性结直肠癌，但这种恶性肿瘤的疗效仍不理想。免疫疗法在该患者群体的治疗中一直进展缓慢。检查点抑制剂，如nivolumab，在广泛应用时效果不佳。然而，对于微卫星不稳定型结直肠癌的亚组患者，使用检查点抑制剂（如 nivolumab）似乎具有变革性，将为晚期疾病患者提供新的治疗选择。涵盖领域：Nivolumab 于 2017 年年中获得监管机构批准，用于治疗错配修复缺陷/微卫星高度不稳定转移性结直肠癌。本综述将总结检查点抑制剂在转移性结直肠癌中的临床证据，重点关注 nivolumab。专家评论：对于错配修复缺陷/微卫星高度不稳定型 mCRC 患者，在一项关键的 II 期试验中，nivolumab 已被证明可产生客观且持续的临床反应。虽然数据有限，但在转移性结直肠癌中增强免疫反应的治疗作用可能会继续扩大。nivolumab 与免疫和非免疫药物联合的进一步临床试验正在进行中。
