Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Division of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Adv Exp Med Biol. 2021;1342:259-272. doi: 10.1007/978-3-030-79308-1_8.
Gastrointestinal (GI) cancers represent a heterogeneous group of malignancies, each with a unique tumor biology that in turn affects response to treatment and subsequent prognosis. The interplay between tumor cells and the local immune microenvironment also varies within each GI malignancy and can portend prognosis and response to therapy. Treatment with immune checkpoint inhibitors has changed the treatment landscape of various solid tumors including (but not limited to) renal cell carcinoma, melanoma, and lung cancer. Advances in the understanding between the interplay between the immune system and tumors cells have led to the integration of immunotherapy as standard of care in various GI malignancies. For example, immunotherapy is now a mainstay of treatment for tumors harboring defects in DNA mismatch repair proteins and tumors harboring a high mutational load, regardless of primary site of origin. Data from recent clinical trials have led to the integration of immunotherapy as standard of care for a subset of gastroesophageal cancers and hepatocellular carcinoma. Here, we outline the current landscape of immunotherapy in GI malignancies and highlight ongoing clinical trials that will likely help to further our understanding of how and when to integrate immunotherapy into the treatment of various GI malignancies.
胃肠道（GI）癌症代表了一组异质性的恶性肿瘤，每种肿瘤都具有独特的肿瘤生物学特性，进而影响治疗反应和后续预后。肿瘤细胞与局部免疫微环境之间的相互作用在每种胃肠道恶性肿瘤中也各不相同，并预示着预后和对治疗的反应。免疫检查点抑制剂的治疗改变了各种实体瘤的治疗格局，包括（但不限于）肾细胞癌、黑色素瘤和肺癌。对免疫系统与肿瘤细胞相互作用的理解的进展导致免疫疗法作为各种胃肠道恶性肿瘤的标准治疗方法得到整合。例如，免疫疗法现在是携带有缺陷的 DNA 错配修复蛋白的肿瘤和携带有高突变负荷的肿瘤的主要治疗方法，无论其原发部位如何。来自最近临床试验的数据导致免疫疗法作为胃食管交界处癌症和肝细胞癌的标准治疗方法的一部分得到整合。在这里，我们概述了胃肠道恶性肿瘤中免疫治疗的现状，并强调了正在进行的临床试验，这些试验可能有助于我们进一步了解如何以及何时将免疫疗法纳入各种胃肠道恶性肿瘤的治疗。
