Memorial Sloan Kettering Cancer Center, New York, New York.
J Surg Oncol. 2021 Mar;123(3):760-774. doi: 10.1002/jso.26357.
Immune checkpoint inhibition (ICI) has transformed the management of metastatic colorectal cancer (mCRC) with mismatch-repair deficiency (dMMR) and microsatellite instability (MSI-H), though this constitutes on average less than 5% of mCRC, and ICI is ineffective in preserved MMR/microsatellite stable disease (pMMR/MSS). Here we review the efficacy of ICI in dMMR/MSI-H mCRC, poor response to ICI in pMMR/MSS mCRC, role for ICI in locally advanced disease, biomarkers of response, novel immunotherapies, and future directions in targeting resistance mechanisms.
免疫检查点抑制(ICI)改变了错配修复缺陷(dMMR)和微卫星不稳定(MSI-H)转移性结直肠癌(mCRC)的治疗方法,尽管这在 mCRC 中平均占比不到 5%,且 ICI 在保留的错配修复/微卫星稳定疾病(pMMR/MSS)中无效。在此,我们回顾了 ICI 在 dMMR/MSI-H mCRC 中的疗效、pMMR/MSS mCRC 中 ICI 反应不佳的情况、ICI 在局部晚期疾病中的作用、反应的生物标志物、新型免疫疗法以及针对耐药机制的未来方向。