晚期食管癌的治疗进展:新辅助和辅助治疗中的免疫疗法
Advancing Esophageal Cancer Treatment: Immunotherapy in Neoadjuvant and Adjuvant Settings.
作者信息
Park Daniel, Jeon Won Jin, Yang Chieh, Castillo Dani Ran
机构信息
University of California, San Francisco-Fresno Branch Campus, Fresno, CA 93701, USA.
Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
出版信息
Cancers (Basel). 2024 Jan 11;16(2):318. doi: 10.3390/cancers16020318.
Locally advanced esophageal cancer (LAEC) poses a significant and persistent challenge in terms of effective treatment. Traditionally, the primary strategy for managing LAEC has involved concurrent neoadjuvant chemoradiation followed by surgery. However, achieving a pathologic complete response (pCR) has proven to be inconsistent, and despite treatment, roughly half of patients experience locoregional recurrence or metastasis. Consequently, there has been a paradigm shift towards exploring the potential of immunotherapy in reshaping the landscape of LAEC management. Recent research has particularly focused on immune checkpoint inhibitors, investigating their application in both neoadjuvant and adjuvant settings. These inhibitors, designed to block specific proteins in immune cells, are meant to enhance the immune system's ability to target and combat cancer cells. Emerging evidence from these studies suggests the possibility of a mortality benefit, indicating that immunotherapy may contribute to improved overall survival rates for individuals grappling with esophageal cancer. This manuscript aims to meticulously review the existing literature surrounding neoadjuvant and adjuvant immunotherapy in the context of LAEC management. The intention is to thoroughly examine the methodologies and findings of relevant studies, providing a comprehensive synthesis of the current understanding of the impact of immunotherapy on esophageal cancer.
局部晚期食管癌(LAEC)在有效治疗方面构成了重大且持续的挑战。传统上,管理LAEC的主要策略包括同步新辅助放化疗,随后进行手术。然而,已证明实现病理完全缓解(pCR)并不一致,并且尽管进行了治疗,仍有大约一半的患者出现局部区域复发或转移。因此,在探索免疫疗法在重塑LAEC管理格局方面的潜力方面出现了范式转变。最近的研究特别关注免疫检查点抑制剂,研究它们在新辅助和辅助治疗中的应用。这些抑制剂旨在阻断免疫细胞中的特定蛋白质,旨在增强免疫系统靶向和对抗癌细胞的能力。这些研究的新证据表明可能有死亡率获益,表明免疫疗法可能有助于提高食管癌患者的总体生存率。本手稿旨在精心回顾LAEC管理背景下有关新辅助和辅助免疫疗法的现有文献。目的是彻底审查相关研究的方法和结果,全面综合当前对免疫疗法对食管癌影响的理解。