Division of Molecular Pathology, The Institute of Cancer Research, Sutton SM25NG, UK.
Division of Medical Oncology, Hospital Policlinic 'Fondazione IRCCS Ca' Granda Ospedale Maggiore', I-20122 Milan, Italy.
Int J Mol Med. 2021 Jun;47(6). doi: 10.3892/ijmm.2021.4930. Epub 2021 Apr 13.
Oesophageal cancer is one of the most aggressive malignancies with limited treatment options, thus resulting in a high morbidity and mortality. With 5‑year survival rates of only 5‑10%, oesophageal cancer holds a dismal prognosis for patients. In order to improve overall survival, the early diagnosis and tools for patient stratification for personalized treatment are urgent needs. A minority of oesophageal cancers belong to the spectrum of Lynch syndrome‑associated cancers and are characterized by microsatellite instability (MSI). Microsatellite instability is a consequence of defective mismatch repair protein functions and it has been well characterized in other gastrointestinal tumours, such as colorectal and gastric cancer. In the latter, high levels of MSI are associated with a better prognosis and with an increased benefit to immune‑based therapies. Therefore, similar therapeutic approaches could offer an opportunity of treatment for oesophageal cancer patients with MSI. Apart from immune checkpoint inhibitors, other immunotherapies such as adoptive T‑cell transfer, peptide vaccine and oncolytic viruses are under investigation in oesophageal cancer patients. In the present review, the rationale and current knowledge about immunotherapies in oesophageal cancer are summarised.
食管癌是一种侵袭性很强的恶性肿瘤,治疗选择有限,因此发病率和死亡率都很高。食管癌患者的 5 年生存率仅为 5%-10%,预后较差。为了提高总体生存率,早期诊断和用于患者分层的个体化治疗工具是当务之急。少数食管癌属于林奇综合征相关癌症的范畴,其特征是微卫星不稳定(MSI)。微卫星不稳定是错配修复蛋白功能缺陷的结果,在其他胃肠道肿瘤(如结直肠癌和胃癌)中已有很好的描述。在后一种情况下,MSI 水平较高与预后较好和免疫治疗获益增加相关。因此,类似的治疗方法可能为 MSI 食管癌患者提供治疗机会。除免疫检查点抑制剂外,其他免疫疗法,如过继性 T 细胞转移、肽疫苗和溶瘤病毒,也正在食管癌患者中进行研究。在本综述中,总结了食管癌免疫治疗的原理和现有知识。