Saoudi González Nadia, Castet Florian, Élez Elena, Macarulla Teresa, Tabernero Josep
Department of Medical Oncology, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
Front Oncol. 2022 Oct 10;12:1021772. doi: 10.3389/fonc.2022.1021772. eCollection 2022.
Gastrointestinal tumours are a heterogeneous group of neoplasms that arise in the gastrointestinal tract and hepatobiliary system. Their incidence is rising globally and they currently represent the leading cause of cancer-related mortality worldwide. Anti-angiogenic agents have been incorporated into the treatment armamentarium of most of these malignancies and have improved survival outcomes, most notably in colorectal cancer and hepatocellular carcinoma. New treatment combinations with immunotherapies and other agents have led to unprecedented benefits and are revolutionising patient care. In this review, we detail the mechanisms of action of anti-angiogenic agents and the preclinical rationale underlying their combinations with immunotherapies. We review the clinical evidence supporting their use across all gastrointestinal tumours, with a particular emphasis on colorectal cancer and hepatocellular carcinoma. We discuss available biomarkers of response to these therapies and their utility in routine clinical practice. Finally, we summarise ongoing clinical trials in distinct settings and highlight the preclinical rationale supporting novel combinations.
胃肠道肿瘤是一组起源于胃肠道和肝胆系统的异质性肿瘤。其发病率在全球范围内呈上升趋势，目前是全球癌症相关死亡的主要原因。抗血管生成药物已被纳入大多数此类恶性肿瘤的治疗手段，并改善了生存结果，在结直肠癌和肝细胞癌中最为显著。免疫疗法和其他药物的新治疗组合带来了前所未有的益处，正在彻底改变患者护理。在本综述中，我们详细阐述了抗血管生成药物的作用机制以及它们与免疫疗法联合使用的临床前理论依据。我们回顾了支持其在所有胃肠道肿瘤中应用的临床证据，特别强调结直肠癌和肝细胞癌。我们讨论了对这些疗法有反应的可用生物标志物及其在常规临床实践中的效用。最后，我们总结了不同环境下正在进行的临床试验，并强调了支持新组合的临床前理论依据。
