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结肠癌免疫治疗的预测生物标志物:现状与未来。

Predictive biomarkers of colon cancer immunotherapy: Present and future.

机构信息

Department of Medical Oncology Cancer Center, West China Hospital, Sichuan University, Sichuan, China.

出版信息

Front Immunol. 2022 Nov 22;13:1032314. doi: 10.3389/fimmu.2022.1032314. eCollection 2022.

Abstract

Immunotherapy has revolutionized colon cancer treatment. Immune checkpoint inhibitors (ICIs) have shown clinical benefits for colon cancer patients, especially those with high microsatellite instability (MSI-H). In 2020, the US Food and Drug Administration (FDA)-approved ICI pembrolizumab as the first-line treatment for metastatic MSI-H colon cancer patients. Additionally, neoadjuvant immunotherapy has presented efficacy in treating early-stage colon cancer patients. Although MSI has been thought of as an effective predictive biomarker for colon cancer immunotherapy, only a small proportion of colon cancer patients were MSI-H, and certain colon cancer patients with MSI-H presented intrinsic or acquired resistance to immunotherapy. Thus, further search for predictive biomarkers to stratify patients is meaningful in colon cancer immunotherapy. Except for MSI, other biomarkers, such as PD-L1 expression level, tumor mutation burden (TMB), tumor-infiltrating lymphocytes (TILs), certain gut microbiota, ctDNA, and circulating immune cells were also proposed to be correlated with patient survival and ICI efficacy in some colon cancer clinical studies. Moreover, developing new diagnostic techniques helps identify accurate predictive biomarkers for colon cancer immunotherapy. In this review, we outline the reported predictive biomarkers in colon cancer immunotherapy and further discuss the prospects of technological changes for biomarker development in colon cancer immunotherapy.

摘要

免疫疗法彻底改变了结肠癌的治疗方式。免疫检查点抑制剂(ICI)为结肠癌患者,特别是高度微卫星不稳定(MSI-H)患者带来了显著的临床获益。2020 年,美国食品和药物管理局(FDA)批准 ICI 药物 pembrolizumab 作为转移性 MSI-H 结肠癌患者的一线治疗药物。此外,新辅助免疫疗法在治疗早期结肠癌患者方面也展现出了疗效。尽管 MSI 已被认为是结肠癌免疫治疗的有效预测生物标志物,但只有一小部分结肠癌患者为 MSI-H,且某些 MSI-H 的结肠癌患者对免疫治疗存在内在或获得性耐药。因此,进一步寻找预测生物标志物来分层患者在结肠癌免疫治疗中具有重要意义。除了 MSI,其他生物标志物,如 PD-L1 表达水平、肿瘤突变负荷(TMB)、肿瘤浸润淋巴细胞(TILs)、特定的肠道微生物群、ctDNA 和循环免疫细胞,也被认为与某些结肠癌临床研究中患者的生存和 ICI 疗效相关。此外,开发新的诊断技术有助于确定结肠癌免疫治疗中准确的预测生物标志物。在本综述中,我们概述了结肠癌免疫治疗中报道的预测生物标志物,并进一步讨论了技术变革在结肠癌免疫治疗中开发生物标志物的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc0e/9722772/d107c156ab72/fimmu-13-1032314-g001.jpg

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