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免疫治疗在胆管癌中的最新进展。

Recent advances of immunotherapy for biliary tract cancer.

机构信息

Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy.

Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

出版信息

Expert Rev Gastroenterol Hepatol. 2021 May;15(5):527-536. doi: 10.1080/17474124.2021.1853527. Epub 2021 Jan 8.

Abstract

: Biliary tract cancer (BTC) is a heterogeneous group of aggressive malignancies comprising intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer, and ampulla of Vater cancer. Although recent years have witnessed the emergence of novel treatment targets, medical therapy remains a compelling challenge in these hepatobiliary malignancies. In order to provide more effective treatment options, immune checkpoint inhibitors (ICIs) are currently under investigation in advanced BTC, with controversial results reported so far.: This review provides an overview regarding current scenario of ICIs and immune-based combinations in advanced BTC, where several novel treatments are currently being developed, some of which have suggested interesting efficacy in recent clinical trials. In addition, we provide a report of ongoing Phase I to III clinical trials assessing ICIs and new immunotherapeutic strategies for advanced BTC.: Although immunotherapy has revolutionized the treatment landscape of several hematological and solid tumors, the role of ICIs and immune-based combinations in advanced BTC is still unclear. Despite ICI monotherapy has reported limited efficacy in this setting, the durable responses observed in sporadic cases suggest that testing patients for MMR, MSI, TMB, and PD-L1 expression is warranted. Results of currently ongoing trials are highly awaited.

摘要

胆道癌(BTC)是一组具有异质性的侵袭性恶性肿瘤,包括肝内胆管癌、肝外胆管癌、胆囊癌和壶腹癌。尽管近年来出现了新的治疗靶点,但这些肝胆恶性肿瘤的药物治疗仍然是一个巨大的挑战。为了提供更有效的治疗选择,免疫检查点抑制剂(ICI)目前正在晚期 BTC 中进行研究,但迄今为止报告的结果存在争议。

这篇综述概述了目前晚期 BTC 中 ICI 和免疫联合治疗的现状,目前正在开发几种新的治疗方法,其中一些在最近的临床试验中显示出了有趣的疗效。此外,我们还报告了正在进行的评估晚期 BTC 中 ICI 和新免疫治疗策略的 I 期至 III 期临床试验。

尽管免疫疗法已经彻底改变了一些血液学和实体瘤的治疗格局,但 ICI 和免疫联合治疗在晚期 BTC 中的作用仍不明确。尽管 ICI 单药治疗在这种情况下疗效有限,但在散发性病例中观察到的持久反应表明,有必要对 MMR、MSI、TMB 和 PD-L1 表达进行检测。目前正在进行的试验的结果备受期待。

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