Evolving Strategies in the Management of Microsatellite Instability-High/Mismatch Repair Deficient Esophagogastric Adenocarcinoma.

IF 4.7 2区医学 Q1 ONCOLOGY

Current Oncology Reports Pub Date : 2025-02-01 Epub Date: 2025-01-03 DOI:10.1007/s11912-024-01624-4

Nicole Baranda Balmaceda, Sunnie S Kim

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引用次数: 0

Abstract

Purpose of review: This review addresses the current treatment paradigm and new advancements in the management of microsatellite instability-high/mismatch repair deficient (MSI-H/dMMR) esophagogastric cancer (EGC).

Recent findings: While chemotherapy and surgery remain the cornerstone of EGC treatment, MSI-H/dMMR tumors harbor high tumor mutational burden and represent a subset of patients who benefit from immune checkpoint inhibitors (ICI). ICI has been incorporated in the front line setting with and without chemotherapy for advanced disease. Recently, ICI has been studied in the perioperative setting for resectable disease. Though perioperative ICI results in improved response rates, it is not yet clear whether this translates to a survival benefit. Despite high response rates with ICI in this patient population, many do not respond to therapy, representing a major challenge in treatment. Preclinical studies have highlighted potential mechanisms of resistance which will guide drug development and clinical trials.

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微卫星不稳定性-高/错配修复缺陷食管胃腺癌的治疗策略的演变。

综述目的：本文综述了微卫星不稳定性-高/错配修复缺陷（MSI-H/dMMR）食管胃癌（EGC）目前的治疗模式和治疗的新进展。最近的研究发现：虽然化疗和手术仍然是EGC治疗的基石，但MSI-H/dMMR肿瘤具有高肿瘤突变负担，并且代表了免疫检查点抑制剂（ICI）受益的一部分患者。ICI已被纳入有或无化疗的晚期疾病的一线设置。最近，ICI在可切除疾病的围手术期进行了研究。尽管围手术期ICI可提高应答率，但尚不清楚这是否转化为生存获益。尽管ICI在这一患者群体中的应答率很高，但许多人对治疗没有反应，这是治疗的主要挑战。临床前研究强调了潜在的耐药机制，这将指导药物开发和临床试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Oncology Reports ONCOLOGY-

CiteScore

8.50

自引率

0.00%

发文量

187

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.