Tang Z H, Chen J L, Liu S Y, Yu X P, Tong H J, Quan Z W
Department of General Surgery, Shanghai Xinhua Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200092,China.
Zhonghua Wai Ke Za Zhi. 2022 Apr 1;60(4):343-350. doi: 10.3760/cma.j.cn112139-20220110-00019.
Biliary tract cancer has insidious onset and high degree of malignancy, and radical resection is often impossible when it is diagnosed.Conversion therapy can achieve tumor downgrading, so that patients who were initially unresectable have a chance to achieve R0 resection.However, due to the high heterogeneity and complex immune microenvironment of biliary tract cancer, conversion therapy is still in the stage of active exploration.As a new type of conversion therapy, combination of targeted therapy and immunotherapy is of great significance to effectively improve the efficiency of conversion therapy.Further exploration of combination mechanism and improvement of immune microenvironment are expected to become the future direction of combination of targeted therapy and immunotherapy.
胆管癌起病隐匿,恶性程度高,确诊时往往无法进行根治性切除。转化治疗可实现肿瘤降期,使最初无法切除的患者有机会实现R0切除。然而,由于胆管癌高度异质性和复杂的免疫微环境,转化治疗仍处于积极探索阶段。作为一种新型的转化治疗,靶向治疗与免疫治疗联合对于有效提高转化治疗效率具有重要意义。进一步探索联合机制和改善免疫微环境有望成为未来靶向治疗与免疫治疗联合的方向。