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免疫治疗与放疗在食管癌中的协同作用:当前知识与未来展望概述。

Synergism Between Immunotherapy and Radiotherapy in Esophageal Cancer: An Overview of Current Knowledge and Future Perspectives.

机构信息

Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy.

Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy.

出版信息

Cancer Biother Radiopharm. 2021 Mar;36(2):123-132. doi: 10.1089/cbr.2020.3643. Epub 2020 Jun 16.

Abstract

Esophageal cancer (EC) is an aggressive neoplasm of the gastrointestinal tract that is usually treated with a combination of chemotherapy, radiotherapy (RT), and/or surgery, according to disease status. Despite the availability of multimodal therapeutic strategies, local recurrence is frequently observed. Immunotherapy is a promising therapeutic approach that is currently highly investigated in association to standard therapies, including RT, with the aim to improve patients' outcomes. A PubMed search was performed with the following keywords in all fields: "esophageal cancer" and "radiotherapy" and "radiation" and "immunotherapy" and "PD-1" and "PD L1." For an overview of ongoing trials, an additional search on ClinicalTrials.gov website was performed using the keywords "esophageal cancer" and "immunotherapy" and "PD-L1" and "CTLA-4" and "radiation" and "radiotherapy." Emerging data from preclinical and clinical studies are suggesting a synergistic effect between immunotherapy and RT. With the aim to update the knowledge of this synergistic immune-mediated antitumor activity and discuss current challenges, the authors summarize published data concerning the basic mechanisms and the effectiveness and tolerance of the combination between immunotherapy and RT for patients with EC, followed by an overview of ongoing clinical trial. Published results encourage the use of personalized therapeutic approaches for EC patients in the future; results from ongoing studies will help to identify the optimal strategies for patient selection and treatment response evaluation.

摘要

食管癌(EC)是一种侵袭性的胃肠道肿瘤,通常根据疾病状况采用化疗、放疗(RT)和/或手术的联合治疗。尽管有多种治疗策略,但局部复发仍经常发生。免疫疗法是一种很有前途的治疗方法,目前正在与包括 RT 在内的标准疗法联合进行深入研究,目的是改善患者的预后。

在所有字段中使用以下关键词在 PubMed 上进行了搜索:“食管癌”和“放疗”和“辐射”和“免疫疗法”和“PD-1”和“PD-L1”。为了概述正在进行的试验,还在 ClinicalTrials.gov 网站上使用以下关键词进行了额外搜索:“食管癌”和“免疫疗法”和“PD-L1”和“CTLA-4”和“辐射”和“放疗”。临床前和临床研究中的新兴数据表明,免疫疗法和 RT 之间存在协同作用。为了更新对这种协同免疫介导的抗肿瘤活性的认识,并讨论当前的挑战,作者总结了关于免疫疗法和 RT 联合治疗 EC 患者的基础机制、有效性和耐受性的已发表数据,随后概述了正在进行的临床试验。

已发表的结果鼓励未来为 EC 患者使用个性化的治疗方法;正在进行的研究结果将有助于确定患者选择和治疗反应评估的最佳策略。

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