免疫疗法在食管癌和胃癌中的作用——进展、挑战与未来策略
Role of Immunotherapy in Gastroesophageal Cancers-Advances, Challenges and Future Strategies.
作者信息
Lynch Emer, Duffy Austin G, Kelly Ronan J
机构信息
Department of Medical Oncology, The Mater Hospital, D07 R2WY Dublin, Ireland.
The Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX 75246, USA.
出版信息
Cancers (Basel). 2023 Nov 14;15(22):5401. doi: 10.3390/cancers15225401.
BACKGROUND
Gastroesophageal cancers (GECs) carry considerable morbidity and mortality, and demonstrate geographical histological variances in addition to molecular heterogeneity. Consequently, the immunogenicity of the different subtypes, which can predict the likelihood of immunotherapy response, can vary. Immune checkpoint inhibitor (ICI) therapy has transformed the treatment of many cancer types over the past decade but has been slower to gain a foothold in the treatment paradigm of GECs.
METHODS
This article reviews the existing evidence and use approvals for immunotherapies and immune-based treatments in GECs, in the neoadjuvant, adjuvant and metastatic disease settings. The challenges of and limitations to ICI application in current clinical practice are examined. Ongoing clinical trials and future directions of research are also considered.
CONCLUSION
ICI therapy has become an established treatment option within GECs, both perioperatively and in advanced disease. However, nuances in terms of its use are not yet fully understood. Ongoing research proposes to broaden the application of immunotherapies in GECs with the potential to continue to improve outcomes.
背景
胃食管癌（GECs）具有相当高的发病率和死亡率，除了分子异质性外，还表现出地理组织学差异。因此，不同亚型的免疫原性可能不同，而免疫原性可预测免疫治疗反应的可能性。在过去十年中，免疫检查点抑制剂（ICI）疗法改变了许多癌症类型的治疗方式，但在GECs的治疗模式中站稳脚跟的速度较慢。
方法
本文回顾了GECs在新辅助、辅助和转移性疾病环境中免疫疗法和基于免疫的治疗的现有证据及使用批准情况。研究了ICI在当前临床实践中的应用挑战和局限性。还考虑了正在进行的临床试验和未来的研究方向。
结论
ICI疗法已成为GECs围手术期和晚期疾病的既定治疗选择。然而，其使用方面的细微差别尚未完全了解。正在进行的研究旨在扩大免疫疗法在GECs中的应用，有望继续改善治疗结果。
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