胃食管腺癌的免疫疗法:管理现状如何?

Katherine M. Bever
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引用次数: 0

摘要

简介和设计本综述总结了支持使用免疫检查点抑制剂(ICIs)治疗胃食管腺癌(GEA)的现有临床数据、目前的批准情况以及指导患者选择这种方法的现有和新兴生物标志物。本综述评估了晚期/转移性胃食管腺癌和可切除胃食管腺癌的临床数据,以及胃食管腺癌患者对 ICIs 反应的生物标志物,包括错配修复缺陷、PDL1 表达、肿瘤突变负荷和 Epstein-Barr 病毒。其他 ICIs 正在开发中。在可切除病例中,将 ICI 与化疗结合使用似乎可以提高病理反应率;但是,需要进行长期随访,以确认这种方法是否能提高生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immunotherapy in gastroesophageal adenocarcinoma: What is the state of management?

Introduction and design

This review summarizes clinical data available that supports the use of immune checkpoint inhibitors (ICIs) in the treatment of gastroesophageal adenocarcinoma (GEA). and current approvals as well as current and emerging biomarkers to guide patient selection for this approach. Included in this review is an assessment of clinical data in advanced/metastatic GEA and resectable GEA as well as biomarkers of response to ICIs in GEA, including mismatch repair deficiency, PDL1 expression, tumor mutation burden, and Epstein-Barr virus.

Results and conclusion

ICIs are active in GEA and both nivolumab and pembrolizumab are approved in in the front-line metastatic setting in combination with chemotherapy. Other ICIs are in development. Incorporation of ICI with chemotherapy appears to improve pathologic response rates in the resectable setting; however, longer term follow up is needed to confirm a survival benefit from this approach.
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