Zhang X L, Fan W X, Du Y Y, Zhang Y, Su F, Hu W Q, Zhao J
Department of Oncology, Changzhi People's Hospital, Changzhi 046000, China.
Graduate School of Shanxi Medical University, Taiyuan 030607, China.
Zhonghua Zhong Liu Za Zhi. 2024 Aug 23;46(8):725-736. doi: 10.3760/cma.j.cn112152-20230904-00116.
In recent years, immune checkpoint inhibitors (ICIs) have been widely used in malignant solid tumors with remarkable efficacy. However, in colorectal cancer (CRC), ICIs have shown significant therapeutic effects only in patients with highly microsatellite unstable/mismatch repair-deficient metastatic CRC and these patients are only a minority of all CRC patients. In contrast, the majority of patients, those with microsatellite stable (MSS)/mismatch repair-complete (pMMR)-type metastatic CRC, could hardly benefit from ICI monotherapies, and immune combination therapies have become the key to solveing this clinical challenge. This article introduces the common patterns and possible mechanisms of immune-combination therapies for MSS/pMMR-type CRC, the exploration and progress made in the application of immune-combination therapies, as well as the possible predictive markers of efficacy of immune therapies. The prospects and directions of ICIs in the treatment of MSS/pMMR-type CRC are also discussed.
近年来,免疫检查点抑制剂(ICI)已广泛应用于恶性实体瘤,疗效显著。然而,在结直肠癌(CRC)中,ICI仅在高度微卫星不稳定/错配修复缺陷的转移性CRC患者中显示出显著的治疗效果,而这些患者仅占所有CRC患者的少数。相比之下,大多数患者,即微卫星稳定(MSS)/错配修复完整(pMMR)型转移性CRC患者,很难从ICI单药治疗中获益,免疫联合治疗已成为解决这一临床挑战的关键。本文介绍了MSS/pMMR型CRC免疫联合治疗的常见模式和可能机制、免疫联合治疗应用中的探索与进展,以及免疫治疗疗效的可能预测标志物。还讨论了ICI在治疗MSS/pMMR型CRC方面的前景和方向。