Németh Zsuzsanna, Rubovszky Gábor
Mellkasi és Hasüregi Daganatok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
Magy Onkol. 2024 Dec 10;68(4):375. Epub 2024 Jun 28.
Treatment of locally advanced rectal cancer involves neoadjuvant chemoradiotherapy (CRT), including induction or consolidation chemotherapy. Introduction of immunotherapy has brought success in several solid tumors and hematological diseases. In colorectal tumors, it was only introduced later. A general predictive biomarker is the deficient mismach repair (dMMR) status and consequent microsatellite instability (MSI-H). In these tumors, immune checkpoint inhibitor (ICI) therapy is the first-choice therapy in metastatic colorectal cancer. ICIs have been used in earlier, non-metastatic stages in several studies, with breakthrough results in the microsatellite-unstable patient group and recently in combination with neoadjuvant CRT in rectal tumor patients with pMMR/MSI-L status. In our report we focused on the recent immune checkpoint inhibitor treatment of metastatic and locally advanced colorectal cancer, as a monotherapy, or combined with chemo- or radiotherapy. We summarize the studies with the most promising results.
局部晚期直肠癌的治疗包括新辅助放化疗（CRT），其中包括诱导化疗或巩固化疗。免疫疗法的引入已在多种实体瘤和血液疾病中取得成功。在结直肠癌中，它的引入较晚。一个通用的预测生物标志物是错配修复缺陷（dMMR）状态以及随之而来的微卫星不稳定（MSI-H）。在这些肿瘤中，免疫检查点抑制剂（ICI）疗法是转移性结直肠癌的首选疗法。在多项研究中，ICI已被用于更早的非转移性阶段，在微卫星不稳定患者组中取得了突破性成果，最近还与新辅助CRT联合用于错配修复功能正常/微卫星稳定低状态（pMMR/MSI-L）的直肠肿瘤患者。在我们的报告中，我们重点关注了转移性和局部晚期结直肠癌最近的免疫检查点抑制剂治疗，作为单一疗法，或与化疗或放疗联合使用。我们总结了最有前景的研究结果。
