Memorial Sloan Kettering Cancer Center, New York, New York.
Clin Adv Hematol Oncol. 2021 Oct;19(10):639-647.
The uses of immune checkpoint inhibitors have now been advanced to include the first-line treatment of esophagogastric cancers. Initially approved for the treatment of chemotherapy-refractory programmed death ligand 1-positive or microsatellite instability (MSI)-high esophagogastric adenocarcinoma, these agents have been shown in earlier-line trials to have an additive benefit with first-line chemotherapy, and superiority to chemotherapy, in MSI-high cancers. Pembrolizumab and nivolumab have received approval for the second-line treatment of esophageal squamous cancer. The addition of nivolumab to first-line chemotherapy in gastric and gastroesophageal junction (GEJ) adenocarcinoma improved survival, progression-free survival, and response, findings that led to regulatory approval. The addition of pembrolizumab to first-line chemotherapy in esophageal and GEJ adenocarcinoma and squamous cancer also improved all outcomes, which led to the approval of pembrolizumab as part of first-line chemotherapy. The addition of pembrolizumab to first-line chemotherapy in human epidermal growth factor receptor 2-positive esophagogastric adenocarcinoma was also recently approved. In addition, the adjuvant use of nivolumab was recently approved in esophageal and GEJ cancer after chemoradiotherapy and surgery in patients with residual disease found at surgery. This article reviews recent advances in the use of immune checkpoint inhibitor therapy in esophagogastric cancers.
免疫检查点抑制剂的用途现已扩展到包括用于治疗胃食管癌症的一线治疗。最初被批准用于治疗化疗难治性程序性死亡配体 1 阳性或微卫星不稳定（MSI）高的胃食管腺癌，这些药物在早期临床试验中已显示与一线化疗具有附加益处，并且在 MSI 高的癌症中优于化疗。派姆单抗和纳武利尤单抗已获准用于二线治疗食管鳞状细胞癌。纳武利尤单抗联合一线化疗治疗胃和胃食管交界处（GEJ）腺癌可改善生存、无进展生存期和缓解率，这些发现促使监管机构批准了该药物。在食管和 GEJ 腺癌和鳞状细胞癌中，帕博利珠单抗联合一线化疗也改善了所有结局，从而批准了帕博利珠单抗作为一线化疗的一部分。在人表皮生长因子受体 2 阳性胃食管腺癌的一线化疗中也加入了派姆单抗。此外，在手术后发现残留疾病的患者中，在化疗和放疗后，纳武利尤单抗的辅助使用最近也被批准用于治疗食管和 GEJ 癌症。本文综述了免疫检查点抑制剂在胃食管癌症中的治疗的最新进展。
