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癌症免疫治疗学会(SITC)临床实践指南:免疫治疗治疗胃肠道癌。

Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gastrointestinal cancer.

机构信息

Charles A. Sammons Cancer Center, Baylor University Medical Center at Dallas, Dallas, Texas, USA

Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

J Immunother Cancer. 2023 Jun;11(6). doi: 10.1136/jitc-2022-006658.

Abstract

Gastrointestinal (GI) cancers, including esophageal, gastroesophageal junction, gastric, duodenal and distal small bowel, biliary tract, pancreatic, colon, rectal, and anal cancer, comprise a heterogeneous group of malignancies that impose a significant global burden. Immunotherapy has transformed the treatment landscape for several GI cancers, offering some patients durable responses and prolonged survival. Specifically, immune checkpoint inhibitors (ICIs) directed against programmed cell death protein 1 (PD-1), either as monotherapies or in combination regimens, have gained tissue site-specific regulatory approvals for the treatment of metastatic disease and in the resectable setting. Indications for ICIs in GI cancer, however, have differing biomarker and histology requirements depending on the anatomic site of origin. Furthermore, ICIs are associated with unique toxicity profiles compared with other systemic treatments that have long been the mainstay for GI cancer, such as chemotherapy. With the goal of improving patient care by providing guidance to the oncology community, the Society for Immunotherapy of Cancer (SITC) convened a panel of experts to develop this clinical practice guideline on immunotherapy for the treatment of GI cancer. Drawing from published data and clinical experience, the expert panel developed evidence- and consensus-based recommendations for healthcare professionals using ICIs to treat GI cancers, with topics including biomarker testing, therapy selection, and patient education and quality of life considerations, among others.

摘要

胃肠道(GI)癌症包括食管癌、胃食管交界处癌、胃癌、十二指肠和远端小肠癌、胆道癌、胰腺癌、结肠癌、直肠癌和肛门癌,这些癌症构成了一组具有异质性的恶性肿瘤,给全球带来了巨大负担。免疫疗法已经改变了多种胃肠道癌症的治疗格局,为一些患者提供了持久的反应和延长的生存时间。具体来说,针对程序性细胞死亡蛋白 1(PD-1)的免疫检查点抑制剂(ICIs),无论是作为单一疗法还是联合治疗方案,已经获得了针对转移性疾病和可切除性疾病的组织部位特异性监管批准。然而,胃肠道癌症中使用 ICIs 的适应症因起源的解剖部位而异,需要不同的生物标志物和组织学要求。此外,与其他长期以来一直是胃肠道癌症主要治疗方法的系统治疗相比,ICIs 具有独特的毒性谱。为了通过为肿瘤学社区提供指导来改善患者的护理,癌症免疫治疗学会(SITC)召集了一组专家来制定本关于免疫疗法治疗胃肠道癌症的临床实践指南。该专家组从已发表的数据和临床经验中为使用 ICIs 治疗胃肠道癌症的医疗保健专业人员制定了基于证据和共识的建议,涵盖了生物标志物检测、治疗选择以及患者教育和生活质量等方面的考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b910/10254964/5614b277e22f/jitc-2022-006658f01.jpg

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