Oncology (Williston Park). 2019 Oct 28;33(10):686506.
Colorectal cancer (CRC) is the third leading cause of cancer deaths, with only 15% of patients surviving 5 years in the metastatic setting. Recent exciting developments in cancer immunotherapy, which involves priming the host's natural immune defenses to recognize, target, and destroy cancer cells effectively, have brought some glimpse of hope in fighting this deadly disease. Although CRC has been shown to evade immune detection like many other cancers do, immunotherapy has been noted to produce some very impressive results in a select group of patients. Patients with mismatch repair-deficient and microsatellite instability-high type CRC have benefited most from recent immunotherapy approaches, leading to US Food and Drug Administration approval of new immunotherapeutic agents in recurrent refractory metastatic disease. Research continues to explore and hopefully define the role of immunotherapy in CRC as single-agent therapy or in combination with other agents in neoadjuvant, adjuvant, and first-line metastatic setting, and to find the optimal combination and sequencing of this new therapeutic approach. One of the most challenging tasks is to find ways to expand the use of immunotherapy to not only a select group of CRC patients but also to all patients with this disease. This article will provide a practical concise overview of the current landscape of immunotherapy in CRC for the practicing oncologist along with a representative case presentation from our community oncology practice.
结直肠癌（CRC）是癌症死亡的第三大主要原因，只有 15%的转移性患者能存活 5 年。癌症免疫疗法的最新进展令人兴奋，它涉及启动宿主的天然免疫防御系统，以有效识别、靶向和破坏癌细胞，为对抗这种致命疾病带来了一线希望。虽然 CRC 像许多其他癌症一样逃避免疫检测，但免疫疗法在一些特定患者中已取得了非常显著的效果。错配修复缺陷和微卫星不稳定高型 CRC 患者从最近的免疫治疗方法中获益最多，这导致美国食品和药物管理局批准了新的免疫治疗药物用于复发性难治性转移性疾病。研究仍在继续探索并希望确定免疫疗法在 CRC 中的作用，作为单一药物治疗或与新辅助、辅助和一线转移性治疗中的其他药物联合应用，并找到这种新治疗方法的最佳组合和序贯。最具挑战性的任务之一是找到方法将免疫疗法不仅扩展到 CRC 的一个特定患者群体，而且扩展到所有患有这种疾病的患者。本文将为肿瘤临床医生提供 CRC 免疫治疗的实用简明概述，并提供我们社区肿瘤实践中的一个代表性病例。
