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免疫疗法在胃食管交界处癌中的应用:治疗现状、挑战与新方向。

Immunotherapy in Esophagogastric Cancer: Treatment Landscape, Challenges, and New Directions.

机构信息

Department of Medicine, Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

J Gastrointest Cancer. 2024 Mar;55(1):153-167. doi: 10.1007/s12029-023-01000-8. Epub 2023 Dec 21.

DOI:10.1007/s12029-023-01000-8
PMID:38127239
Abstract

BACKGROUND

Cancers of the upper gastrointestinal tract represent a lethal disease entity comprising the esophagus, gastroesophageal junction, and stomach. The backbone of therapy in esophagogastric cancers has predominantly been chemotherapy-based. However, over the last decade, with the debut of immune checkpoint inhibitors, sophisticated molecular testing, and a more comprehensive understanding of the tumor microenvironment, immunotherapy has been incorporated into the treatment of localized and advanced esophagogastric cancers with promising results.

PURPOSE

This study aimed to review the unique tumor microenvironment and role of immunotherapy in esophagogastric cancers.

METHODS

We conducted a systematic review of clinical and translational research for immunotherapy in esophagogastric cancers.

RESULTS

This article will explore the unique tumor microenvironment in gastroesophageal cancers, the role of immunotherapy in localized and advanced disease, challenges in management, and new therapeutic approaches in clinical trials.

CONCLUSION

With further exploration into targeted therapy and immunotherapy, we anticipate the emergence of novel treatments that will improve survival and quality of life in patients with esophagogastric cancers.

摘要

背景

上消化道癌症是一种致命的疾病实体,包括食管、胃食管交界处和胃。食管胃癌症的治疗基础主要是基于化疗。然而,在过去十年中,随着免疫检查点抑制剂、复杂的分子检测以及对肿瘤微环境的更全面理解的出现,免疫疗法已经被纳入局部和晚期食管胃癌症的治疗中,并取得了有希望的结果。

目的

本研究旨在综述食管胃癌症中独特的肿瘤微环境和免疫疗法的作用。

方法

我们对食管胃癌症免疫疗法的临床和转化研究进行了系统综述。

结果

本文将探讨胃食管癌症中独特的肿瘤微环境、免疫疗法在局限性和晚期疾病中的作用、管理中的挑战以及临床试验中的新治疗方法。

结论

随着对靶向治疗和免疫疗法的进一步探索,我们预计将出现新的治疗方法,改善食管胃癌症患者的生存和生活质量。

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J Gastrointest Cancer. 2024 Mar;55(1):153-167. doi: 10.1007/s12029-023-01000-8. Epub 2023 Dec 21.
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Association of PD-L1 Expression and Other Variables With Benefit From Immune Checkpoint Inhibition in Advanced Gastroesophageal Cancer: Systematic Review and Meta-analysis of 17 Phase 3 Randomized Clinical Trials.PD-L1 表达与其他变量与晚期胃食管交界癌免疫检查点抑制获益的关系:17 项 3 期随机临床试验的系统评价和荟萃分析。
JAMA Oncol. 2022 Oct 1;8(10):1456-1465. doi: 10.1001/jamaoncol.2022.3707.
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Predicting response to immunotherapy in gastric cancer via multi-dimensional analyses of the tumour immune microenvironment.通过肿瘤免疫微环境的多维分析预测胃癌对免疫治疗的反应。
Nat Commun. 2022 Aug 18;13(1):4851. doi: 10.1038/s41467-022-32570-z.
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Neoadjuvant Nivolumab Plus Ipilimumab and Adjuvant Nivolumab in Localized Deficient Mismatch Repair/Microsatellite Instability-High Gastric or Esophagogastric Junction Adenocarcinoma: The GERCOR NEONIPIGA Phase II Study.新辅助纳武利尤单抗联合伊匹单抗和辅助纳武利尤单抗治疗局部缺陷错配修复/微卫星不稳定高型胃或胃食管结合部腺癌:GERCOR NEONIPIGA Ⅱ期研究。
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Pembrolizumab in microsatellite instability high or mismatch repair deficient cancers: updated analysis from the phase II KEYNOTE-158 study.帕博利珠单抗治疗微卫星高度不稳定或错配修复缺陷型癌症:来自 II 期 KEYNOTE-158 研究的更新分析。
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MATTERHORN: phase III study of durvalumab plus FLOT chemotherapy in resectable gastric/gastroesophageal junction cancer.胃/胃食管结合部可切除癌患者中 durvalumab 联合 FLOT 化疗的 III 期研究(Matterhorn 研究)
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