The current status of immunotherapy and future horizon in the treatment of metastatic and locally advanced gastroesophageal adenocarcinoma.

IF 3.6 3区 医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
Expert Opinion on Biological Therapy Pub Date : 2024-09-01 Epub Date: 2024-08-28 DOI:10.1080/14712598.2024.2395921
Izuma Nakayama, Kohei Shitara
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引用次数: 0

Abstract

Introduction: Immunochemotherapy with PD-1 blockade has been established as the current standard first-line therapy for patients with mGEA. Reviewing the history of clinical trials offers valuable insight into the evolution of immune oncology in mGEA, paving the way for future advancements in this field.

Areas covered: This review summarizes the findings of previous clinical trials related to immunotherapy for patients with GEA in the metastatic and locally advanced setting. We also introduce ongoing clinical trials to address the current challenging issues in clinical practice.

Expert opinion: In general, GEA exhibits intermediate immunogenic characteristics with heterogeneous expressions, and responders to anti-PD-(L)1 therapy are mostly enriched to patients with specific genomic profiles such as MSI-H, high PD-L1 expression, high TMB, and EBV-associated type. Co-administration with anti-angiogenic agents or simultaneous blockade of immune checkpoint molecules is being explored to offer benefit of immunotherapy for more patients. We hope that CLDN18.2 and upcoming targets like FGFR2b will complement the treatment niche of immunotherapy in the field of mGEA. Bispecific antibodies, antibody drug conjugates, CAR-T, and vaccine are anticipated to enhance efficacy and expand the scope of immunotherapy.

免疫疗法治疗转移性和局部晚期胃食管腺癌的现状和前景。
简介使用PD-1阻断剂的免疫化疗已被确定为目前mGEA患者的标准一线疗法。回顾临床试验的历史可以深入了解免疫肿瘤学在 mGEA 中的发展,为该领域未来的发展铺平道路:本综述总结了以往针对转移性和局部晚期GEA患者的免疫疗法相关临床试验结果,我们还介绍了正在进行的临床试验,以解决目前临床实践中的挑战性问题:一般来说,GEA表现出中间免疫原性特征,具有异质性表达,对抗PD-(L)1治疗有反应的患者大多具有特定的基因组特征,如MSI-H、高PD-L1表达、高TMB和EBV相关型。目前正在探索与抗血管生成药物联合用药或同时阻断免疫检查点分子,以使更多患者受益于免疫疗法。我们希望,CLDN18.2 和 FGFR2b 等新靶点能补充 mGEA 领域免疫疗法的治疗空白。双特异性抗体、抗体药物共轭物、CAR-T 和疫苗有望提高疗效并扩大免疫疗法的范围。
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来源期刊
Expert Opinion on Biological Therapy
Expert Opinion on Biological Therapy 医学-生物工程与应用微生物
CiteScore
8.60
自引率
0.00%
发文量
96
审稿时长
3-8 weeks
期刊介绍: Expert Opinion on Biological Therapy (1471-2598; 1744-7682) is a MEDLINE-indexed, international journal publishing peer-reviewed research across all aspects of biological therapy. Each article is structured to incorporate the author’s own expert opinion on the impact of the topic on research and clinical practice and the scope for future development. The audience consists of scientists and managers in the healthcare and biopharmaceutical industries and others closely involved in the development and application of biological therapies for the treatment of human disease. The journal welcomes: Reviews covering therapeutic antibodies and vaccines, peptides and proteins, gene therapies and gene transfer technologies, cell-based therapies and regenerative medicine Drug evaluations reviewing the clinical data on a particular biological agent Original research papers reporting the results of clinical investigations on biological agents and biotherapeutic-based studies with a strong link to clinical practice Comprehensive coverage in each review is complemented by the unique Expert Collection format and includes the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results; Article Highlights – an executive summary of the author’s most critical points.
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