Department of Radiation Oncology, Centre Antoine-Lacassagne, 33 Av. de Valombrose, Nice 06100, France.
Department of Medical Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Crit Rev Oncol Hematol. 2024 Jul;199:104381. doi: 10.1016/j.critrevonc.2024.104381. Epub 2024 May 11.
With a significant global impact, treatment of gastrointestinal (GI) cancers still presents with challenges, despite current multimodality approaches in advanced stages. Clinical trials are expanding for checkpoint inhibition (ICI) combined with radiation therapy (RT). This review intends to offer a comprehensive image of the current data regarding the effectiveness of this association, and to reflect on possible directions to further optimize the results.
Several early phase studies demonstrated encouraging potential. However, translating preclinical outcomes to clinical settings proves challenging, especially in immunologically "cold" environments. GI cancers exhibit heterogeneity, requiring tailored approaches based on disease stage and patient characteristics. Current results, though promising, lack the power of evidence to influence the general practice.
Finding biomarkers for identifying or converting resistant cancers is essential for maximizing responses, moreover in this context strategic RT parameters need to be carefully considered. Our review emphasizes the significance of having a thorough grasp of how immunology, tumour biology, and treatment settings interact in order to propose novel research avenues and efficient GI cancer therapy.
尽管目前在晚期阶段采用了多种治疗方法,但胃肠道(GI)癌症的治疗仍然具有挑战性,具有重大的全球影响。临床试验正在扩大检查点抑制(ICI)联合放射治疗(RT)的范围。本综述旨在全面介绍关于这种联合治疗有效性的现有数据,并思考进一步优化结果的可能方向。
几项早期研究显示出令人鼓舞的潜力。然而,将临床前结果转化为临床环境具有挑战性,特别是在免疫“冷”环境中。GI 癌症表现出异质性,需要根据疾病阶段和患者特征制定针对性的方法。尽管目前的结果很有希望,但缺乏足够的证据来影响一般实践。
寻找用于识别或转化耐药癌症的生物标志物对于最大限度地提高反应至关重要,此外,在这种情况下,需要仔细考虑放射治疗参数的策略。我们的综述强调了深入了解免疫、肿瘤生物学和治疗环境如何相互作用以提出新的研究途径和有效的 GI 癌症治疗方法的重要性。