Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Humanities, Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Hematol Oncol. 2019 Apr 24;12(1):42. doi: 10.1186/s13045-019-0730-9.
Gastrointestinal (GI) malignant neoplasms have a high global incidence and treatment prospects for patients with advanced GI tumors are dismal. PD-1/PD-L1 inhibitors emerged as a frontline treatment for several types of cancer. However, the shortcomings of PD-1/PD-L1 inhibitors have been observed, including low objective response rates and acquired tumor resistance, especially in patients receiving PD-1/PD-L1 inhibitors as a single treatment. Accumulating evidence from clinical trials increasingly suggests that combined immunotherapies enhance therapeutic responses in patients with malignances, especially for GI tumors which have a complex matrix, and significant molecular and immunological differences. Preclinical and clinical studies suggest there are advantages to combined immunological regimens, which represents the next logical step in this field, although further research is necessary. This literature review explores the current limitations of monotherapies, before critically discussing the rationale behind combination regimens. Then, we provide a summary of the clinical applications for gastrointestinal cancers.
胃肠道(GI)恶性肿瘤在全球的发病率较高,晚期胃肠道肿瘤患者的治疗前景黯淡。PD-1/PD-L1 抑制剂已成为多种癌症的一线治疗药物。然而,PD-1/PD-L1 抑制剂存在一些缺点,包括客观反应率低和获得性肿瘤耐药性,尤其是在接受 PD-1/PD-L1 抑制剂单一治疗的患者中。越来越多的临床试验证据表明,联合免疫疗法可增强恶性肿瘤患者的治疗反应,尤其是对于具有复杂基质、显著分子和免疫差异的胃肠道肿瘤。临床前和临床研究表明,联合免疫治疗方案具有优势,这是该领域的下一步逻辑发展,尽管还需要进一步的研究。本文综述了单药治疗的局限性,然后批判性地讨论了联合治疗方案的原理。接着,我们总结了胃肠道癌症的临床应用。