Department of General Surgery, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China.
Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
World J Gastroenterol. 2023 Jul 14;29(26):4174-4185. doi: 10.3748/wjg.v29.i26.4174.
Neuroendocrine neoplasms (NENs) are rare heterogeneous tumors that can develop in almost any organ, with the digestive organs, including the gastrointestinal tract and pancreas being the most commonly affected sites. Despite the fact that advances in initial therapies have progressed, there is presently no recognized effective treatment for advanced NEN. Immune checkpoint inhibitors (ICIs) have shown superior efficacy in treating several types of solid tumors. Despite their successful role in the treatment of partial NENs, such as small cell lung cancer, and Merkel cell carcinoma, the role of ICIs in most of the NENs remains limited. Nevertheless, due to their specific anti-tumor mechanisms and acceptable safety profile, ICIs are a promising avenue for further study in NENs therapy. Recent clinical trials have illustrated that combination therapy with ICI is more efficient than monotherapy, and multiple clinical trials are constantly ongoing to evaluate the efficacy and safety of these combination therapies. Therefore, the purpose of this review is to provide a comprehensive summary of the clinical progress of immunotherapy in NENs affecting the digestive system, with a specific emphasis on the application of programmed cell death protein 1/programmed death receptor ligand 1 inhibitor. Furthermore, this review has an exploration of the potential beneficiary population and the inherent value of utilizing immunotherapy in the management of NENs.
神经内分泌肿瘤(NENs)是一种罕见的异质性肿瘤,可以在几乎任何器官中发生,其中消化道和胰腺是最常受影响的部位。尽管初始治疗的进展已经取得了进展,但目前还没有公认的治疗晚期 NEN 的有效方法。免疫检查点抑制剂(ICIs)在治疗多种实体肿瘤方面显示出了优异的疗效。尽管它们在治疗部分 NENs 方面取得了成功,如小细胞肺癌和 Merkel 细胞癌,但在大多数 NENs 中的作用仍然有限。然而,由于其独特的抗肿瘤机制和可接受的安全性,ICI 是 NEN 治疗中进一步研究的有前途的途径。最近的临床试验表明,ICI 联合治疗比单药治疗更有效,并且多个临床试验正在进行中,以评估这些联合疗法的疗效和安全性。因此,本综述的目的是全面总结影响消化系统的 NENs 的免疫治疗的临床进展,特别关注程序性细胞死亡蛋白 1/程序性死亡受体配体 1 抑制剂的应用。此外,本综述还探讨了免疫治疗在 NENs 管理中的潜在受益人群和固有价值。