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免疫疗法治疗结肠癌的10年生存率综述

A Review of 10-Year Survivability of Immunotherapy in the Management of Colon Cancer.

作者信息

Okoye Chiugo, Tran My, Soladoye Elizabeth, Akahara Darlington E, Emeasoba Chinemerem M, Ojinna Blessing T, Anasonye Emmanuel, Obadare Oyindamola O, Diala Chiamaka S, Salaudeen Bolanle H, Evbayekha Endurance O, Okobi Okelue E

机构信息

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Internal Medicine, Baptist Health-University of Arkansas for Medical Sciences - Arkansas, North Little Rock, USA.

出版信息

Cureus. 2023 Aug 9;15(8):e43189. doi: 10.7759/cureus.43189. eCollection 2023 Aug.

Abstract

Colon cancer is one of the most common cancers in the United States of America. In addition to conventional treatment approaches such as surgery, chemotherapy, and radiation for colorectal cancer, immunotherapy has gained recognition over the past few years. However, its effectiveness in colorectal cancer treatment is controversial. Our study investigates the survival and progression-free rates of immunotherapy for different types of colorectal cancer over the last 10 years. We conducted literature reviews from various clinical trials and research studies to evaluate immunotherapy's role in colorectal cancer treatment. We also investigated how it affects clinical outcomes. We discovered a range of effective immunotherapy approaches targeting various growth factors and signaling pathways. These modalities include monoclonal antibodies aimed at growth factors such as epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), human epidermal growth factor receptor 2 (HER2), and downstream signaling pathways such as mitogen-activated protein kinase (MAPK), kirsten rat sarcoma viral oncogene (KRAS), B-raf proto-oncogene, serine/threonine kinase (BRAF), and phosphatase and tensin homolog (PTEN). Additionally, we identified immune checkpoint inhibitors, such as cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitors and programmed cell death ligand 1 (PD-L1) inhibitors, as well as target therapy and adoptive cell therapy as promising immunotherapeutic options. Nevertheless, the application of immunotherapy remains highly limited due to various factors influencing survival and progression-free rates, including tumor microenvironment, microsatellite instability, immune checkpoint expression, and gut microbiome. Additionally, its effectiveness is restricted to a small subgroup of patients, accompanied by side effects and the development of drug resistance mechanisms. To unlock its full potential, further clinical trials and research on molecular pathways in colorectal cancer are imperative. This will ultimately enhance drug discovery success and lead to more effective clinical management approaches.

摘要

结肠癌是美国最常见的癌症之一。除了用于结直肠癌的传统治疗方法,如手术、化疗和放疗外,免疫疗法在过去几年中也获得了认可。然而,其在结直肠癌治疗中的有效性存在争议。我们的研究调查了过去10年中免疫疗法对不同类型结直肠癌的生存率和无进展率。我们对各种临床试验和研究进行了文献综述,以评估免疫疗法在结直肠癌治疗中的作用。我们还研究了它如何影响临床结果。我们发现了一系列针对各种生长因子和信号通路的有效免疫疗法。这些方式包括针对表皮生长因子(EGF)、血管内皮生长因子(VEGF)、肝细胞生长因子(HGF)、人表皮生长因子受体2(HER2)等生长因子的单克隆抗体,以及丝裂原活化蛋白激酶(MAPK)、 Kirsten大鼠肉瘤病毒癌基因(KRAS)、B-raf原癌基因、丝氨酸/苏氨酸激酶(BRAF)和磷酸酶和张力蛋白同源物(PTEN)等下游信号通路。此外,我们确定免疫检查点抑制剂,如细胞毒性T淋巴细胞相关抗原4(CTLA-4)抑制剂和程序性细胞死亡配体1(PD-L1)抑制剂,以及靶向治疗和过继性细胞治疗是有前景的免疫治疗选择。然而,由于影响生存率和无进展率的各种因素,包括肿瘤微环境、微卫星不稳定性、免疫检查点表达和肠道微生物群,免疫疗法的应用仍然非常有限。此外,其有效性仅限于一小部分患者,同时伴有副作用和耐药机制的发展。为了充分发挥其潜力,对结直肠癌分子途径进行进一步的临床试验和研究势在必行。这最终将提高药物研发的成功率,并带来更有效的临床管理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f45c/10485874/ab7de36244e5/cureus-0015-00000043189-i01.jpg

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