Puhr Hannah Christina, Reiter Thorsten J, Preusser Matthias, Prager Gerald W, Ilhan-Mutlu Aysegül
Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Cancers (Basel). 2023 Mar 22;15(6):1900. doi: 10.3390/cancers15061900.
The overall survival expectancy of localized gastroesophageal cancer patients still remains under 5 years despite advances in neoadjuvant and adjuvant treatment strategies in recent years. For almost a decade, immunotherapy has been successfully implemented as a first-line treatment for various oncological diseases in advanced stages. In the case of advanced gastroesophageal cancer, 2021 witnessed several approvals of immune checkpoint inhibitor therapies by different authorities. Although it is still a debate whether this treatment should be restricted to a certain subgroup of patients based on biomarker selection, immunotherapy agents are making remarkable steps in resectable settings as well. The Checkmate-577 study demonstrated significant benefits of nivolumab as an adjuvant treatment for resectable esophageal and gastroesophageal junction tumors and thereby obtained approvals both from U.S. American and European authorities. First results of further potential practice-changing clinical trials are expected in 2023, which might change the treatment armamentarium for resectable gastroesophageal cancers significantly. This review aims to demonstrate the advances of immunotherapy and targeted therapies in treatment of localized gastric, gastroesophageal junction and esophageal tumors and gives a short summary on promising ongoing clinical trials.
尽管近年来新辅助和辅助治疗策略取得了进展，但局部晚期胃食管癌患者的总生存预期仍低于5年。近十年来，免疫疗法已成功作为晚期各种肿瘤疾病的一线治疗方法。就晚期胃食管癌而言，2021年不同权威机构批准了多种免疫检查点抑制剂疗法。尽管基于生物标志物选择，这种治疗是否应局限于特定亚组患者仍存在争议，但免疫治疗药物在可切除情况下也取得了显著进展。Checkmate-577研究证明了纳武利尤单抗作为可切除食管及胃食管交界肿瘤辅助治疗的显著益处，因此获得了美国和欧洲权威机构的批准。预计2023年将有进一步可能改变临床实践的临床试验的初步结果，这可能会显著改变可切除胃食管癌的治疗手段。这篇综述旨在展示免疫疗法和靶向疗法在局部晚期胃癌、胃食管交界癌和食管癌治疗中的进展，并简要总结正在进行的有前景的临床试验。
