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DNA错配修复缺陷/微卫星高度不稳定型结直肠癌新辅助治疗中程序性死亡受体1阻断疗法

PD-1 blockade in neoadjuvant setting of DNA mismatch repair-deficient/microsatellite instability-high colorectal cancer.

作者信息

Liu Ding-Xin, Li Dan-Dan, He Wan, Ke Chuan-Feng, Jiang Wu, Tang Jing-Hua, Kong Ling-Heng, Li Yuan, Sui Qiao-Qi, Xiao Bin-Yi, Li Wei-Rong, Hong Zhi-Gang, Xu Rui-Hua, Pan Zhi-Zhong, Zhang Xiao-Shi, Ding Pei-Rong

机构信息

State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.

Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.

出版信息

Oncoimmunology. 2020 Jan 22;9(1):1711650. doi: 10.1080/2162402X.2020.1711650. eCollection 2020.

Abstract

: Although PD-1 blockade has significantly improved the survival of metastatic colorectal cancer with DNA Mismatch Repair-Deficient/Microsatellite Instability-High (MSI-H), the data on neoadjuvant setting is limited. : In this retrospective study, we enrolled eight patients with advanced MSI-H colorectal cancer from three hospitals. Four patients are locally advanced and four are metastatic. All the patients received at least two doses of PD-1 antibody with or without chemotherapy as neoadjuvant therapy. The aim of the present study was to evaluate the short-term efficacy and toxicities of this strategy. : All the enrolled eight patients had a major response in imaging and/or pathological evaluation. Five of the seven resected patients were evaluated as pathological complete response. One patient without surgery has a clinical complete response (cCR) tumor response. : Neoadjuvant PD-1 blockade induced tumor regression with a major clinical and pathological response in advanced dMMR/MSI-H colorectal cancer. Further studies are required to evaluate the long-term effect of this strategy.

摘要

尽管程序性死亡受体1(PD-1)阻断疗法显著提高了错配修复缺陷/微卫星高度不稳定(MSI-H)转移性结直肠癌患者的生存率,但新辅助治疗方面的数据有限。在这项回顾性研究中,我们纳入了来自三家医院的8例晚期MSI-H结直肠癌患者。4例为局部晚期,4例为转移性。所有患者均接受了至少两剂PD-1抗体,联合或不联合化疗作为新辅助治疗。本研究的目的是评估该治疗策略的短期疗效和毒性。所有纳入的8例患者在影像学和/或病理评估中均有主要反应。7例接受手术的患者中有5例被评估为病理完全缓解。1例未接受手术的患者有临床完全缓解(cCR)的肿瘤反应。新辅助PD-1阻断疗法在晚期错配修复缺陷/微卫星高度不稳定(dMMR/MSI-H)结直肠癌中诱导了肿瘤退缩,并产生了主要的临床和病理反应。需要进一步研究来评估该治疗策略的长期效果。

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