Yi Zhang, Zheng Li, Ying Huang, Yong Xu, Bingwen Zou
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引用次数: 0
摘要
简介:食管癌(EC),尤其是食管鳞状细胞癌(ESCC)在全球范围内具有发病率高、预后差的特点,因此需要采用免疫疗法等新型治疗方法。本综述探讨了免疫检查点抑制剂(ICIs)对ESCC的影响,尤其关注PD-1/PD-L1和CTLA-4抑制剂。我们在2010年1月至2023年12月期间对包括PubMed、Web of Science和EMBASE在内的数据库进行了文献检索,旨在确定免疫疗法用于ESCC的进展、挑战和未来方向:我们详细分析了评估 ICIs 作为单一疗法以及与化疗、放疗和靶向疗法联合治疗局部晚期 ESCC 疗效的临床试验。我们的研究结果凸显了ICIs带来的显著生存益处,尽管不同患者群体的疗效各不相同,但我们强调需要精确的生物标志物来定制治疗策略:将免疫疗法纳入ESCC治疗范式代表着一种重大转变,可改善生存结果。未来的研究应侧重于优化联合疗法和新型免疫治疗药物,并结合基因和肿瘤微环境分析来提高患者选择和治疗效果。
Advancements in immunotherapy for advanced esophageal squamous cell carcinoma: a comprehensive review of current strategies and future directions.
Introduction: Esophageal cancer (EC), particularly esophageal squamous cell carcinoma (ESCC), is characterized by high incidence and poor prognosis worldwide, necessitating novel therapeutic approaches like immunotherapy. This review explores the impact of immune checkpoint inhibitors (ICIs) on ESCC, especially focusing on PD-1/PD-L1 and CTLA-4 inhibitors. Our literature search, conducted across databases including PubMed, Web of Science, and EMBASE, from January 2010 to December 2023, aimed at identifying advancements, challenges, and future directions in the use of immunotherapy for ESCC.
Areas covered: We provide a detailed analysis of clinical trials evaluating the efficacy of ICIs as monotherapy and in combination with chemotherapy, radiotherapy, and targeted therapy for locally advanced ESCC. Our findings highlight the significant survival benefits offered by ICIs, albeit with varying efficacy across patient populations, emphasizing the need for precise biomarkers to tailor treatment strategies.
Expert opinion: The integration of immunotherapy into the ESCC treatment paradigm represents a significant shift, improving survival outcomes. Future research should focus on optimizing combination therapies and novel immunotherapeutic agents, incorporating genetic and tumor microenvironment analyses to enhance patient selection and treatment efficacy.
期刊介绍:
Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology.
Articles focus on the following key areas:
• Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines
• Performance and benefits of newly approved therapeutic agents
• New diagnostic approaches
• Screening and patient stratification
• Pharmacoeconomic studies
• New therapeutic indications for existing therapies
• Adverse effects, occurrence and reduction
• Prospects for medicines in late-stage trials approaching regulatory approval
• Novel treatment strategies
• Epidemiological studies
• Commentary and comparison of treatment guidelines
Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.