Immunotherapy in gastrointestinal cancers: current strategies and future directions - a literature review.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI:10.1097/MS9.0000000000002757
Serene El Fil, Olivier Uwishema, Aisha Rizwan Ahmed, Tanya Ratnani, Ameen Rupani, Sarah Mshaymesh
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引用次数: 0

Abstract

Introduction: The National Cancer Institute defines the disease of "cancer" as a group of disorders in which aberrant cells proliferate uncontrollably and have the potential to infiltrate neighboring tissues. It is well established that cancer remains a significant etiology contributing to worldwide mortality. Gastrointestinal (GI) neoplasms are a type of cancer that affects the digestive system and adds to the total cancer burden. Conventionally, several therapies have been employed, such as radiation and chemotherapy; nevertheless, their adverse effects have prompted the need for an improved therapeutic alternative. Immunotherapy thus became a notable medium of treatment for several malignancies, including tumors of the GI tract.

Aim: This comprehensive review seeks to provide insight on future directions and prospective therapies under development, as well as information regarding the present strategies utilized to mitigate one of the primary forms of cancer, GI cancer.

Methods: A detailed analysis of the existing literature on GI cancers has been conducted. Several databases were employed to gather this information, mainly PubMed/MEDLINE. Different aspects of the disease were considered when searching the databases to provide a comprehensive review of the current and future strategies being incorporated to mitigate the negative consequences of this disease.

Results: Many strategies are being used currently, and some are still under development. These comprise the usage of immune checkpoint inhibitors (ICIs), cytokine therapy, cancer vaccines, oncolytic viruses, and adoptive cell therapy. For instance, various monoclonal antibodies have been developed to inhibit the immunomodulatory effects of programmed death-1 and programmed death-1 ligand. There are also results of several clinical trials showing significant benefits and many changes are introduced to make the best of these strategies and minimize the challenges to group sizes. These challenges include overcoming the tumor's immunosuppressive environment, finding suitable predictive biomarkers, and reducing the adverse effects. Additionally, several novel immunotherapeutic approaches, such as chimeric antigen receptor T-cell (CAR-T) therapy, are being studied. In 2017, the US FDA approved the use of two CAR-T therapies, which marks a major milestone following extensive research and clinical trials. New approaches such as toll-like receptor-directed and helminth-based immunotherapies are being developed for the treatment of GI cancers as well. These therapies, along with targeted treatments, represent the future of immunotherapy in GI cancers.

Conclusion: Immunotherapy plays a significant role in the different types of GI cancers. However, optimizing these treatments will require overcoming barriers such as immune resistance, minimizing side effects, and improving the selection of patients through biomarkers. Continued research into these novel therapies and the mechanisms of immune modulation will be key to maximizing the therapeutic benefits of immunotherapy in the future.

免疫治疗在胃肠道癌症:目前的策略和未来的方向-文献综述。
简介:美国国家癌症研究所将“癌症”定义为一组异常细胞不受控制地增殖并有可能浸润邻近组织的疾病。众所周知,癌症仍然是导致全球死亡的一个重要病因。胃肠道(GI)肿瘤是一种影响消化系统的癌症,增加了总体癌症负担。传统上,有几种治疗方法,如放疗和化疗;然而,它们的副作用促使人们需要一种改进的治疗方法。免疫疗法因此成为治疗包括胃肠道肿瘤在内的几种恶性肿瘤的重要手段。目的:这篇全面的综述旨在提供对未来方向和正在开发的前瞻性治疗方法的见解,以及关于目前用于减轻主要癌症之一GI癌的策略的信息。方法:对已有的有关胃肠道肿瘤的文献进行详细分析。几个数据库被用来收集这些信息,主要是PubMed/MEDLINE。在检索数据库时,考虑了该疾病的不同方面,以便全面审查正在纳入的减轻该疾病负面后果的当前和未来战略。结果:许多策略目前正在使用,有些仍在开发中。这些包括免疫检查点抑制剂(ICIs)、细胞因子疗法、癌症疫苗、溶瘤病毒和过继细胞疗法的使用。例如,已经开发出多种单克隆抗体来抑制程序性死亡-1和程序性死亡-1配体的免疫调节作用。一些临床试验的结果也显示了显著的好处,并引入了许多变化,以充分利用这些策略并最大限度地减少对群体规模的挑战。这些挑战包括克服肿瘤的免疫抑制环境,寻找合适的预测性生物标志物,以及减少不良反应。此外,一些新的免疫治疗方法,如嵌合抗原受体t细胞(CAR-T)治疗,正在研究中。2017年,美国FDA批准了两种CAR-T疗法的使用,这是经过广泛研究和临床试验后的一个重要里程碑。新的方法,如toll样受体导向和蠕虫为基础的免疫疗法也正在开发用于治疗胃肠道癌症。这些疗法与靶向治疗一起,代表了胃肠道癌症免疫治疗的未来。结论:免疫治疗在不同类型的胃肠道肿瘤中发挥着重要作用。然而,优化这些治疗方法将需要克服免疫抵抗等障碍,最大限度地减少副作用,并通过生物标志物改善患者的选择。对这些新疗法和免疫调节机制的持续研究将是未来最大化免疫疗法治疗效益的关键。
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
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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