胃肠神经内分泌肿瘤免疫治疗策略的发展

IF 4.7 2区 医学 Q2 ONCOLOGY
Current Treatment Options in Oncology Pub Date : 2025-02-01 Epub Date: 2025-01-23 DOI:10.1007/s11864-024-01283-4
Arielle Urman, Ian Schonman, Ana De Jesus-Acosta
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引用次数: 0

摘要

观点声明:神经内分泌肿瘤(NENs)的治疗是根据肿瘤的起源部位、分级和分化而定的。NENs主要分为两种类型:高分化神经内分泌肿瘤(NETs)和低分化神经内分泌癌(NECs),前者生长速度较慢,侵袭性较弱;后者侵袭性较强,较难治疗。NETs的治疗选择范围从生长抑素类似物和mTOR抑制剂到肽受体放射性核素治疗(PRRT)与葡酸镥-177。在病情进展较快的情况下,也可以考虑细胞毒性化疗。相比之下,化疗在治疗NECs中起着核心作用,通常遵循类似于治疗小细胞肺癌的方案。NENs新疗法的开发正在取得令人兴奋的进展。受到免疫疗法在其他癌症中的成功的启发,临床试验已经开始探索其在NENs中的潜力。早期研究结果表明,免疫检查点抑制剂(ICIs)可能会带来益处,特别是对高级别NETs和nec患者。然而,由于NENs具有免疫上的“冷”肿瘤微环境,这意味着它们不太可能引发免疫反应,因此需要新的策略来提高ICI的疗效。为了克服这一挑战,研究人员正在探索创新的方法,例如联合双重ICIs或将ICIs与其他治疗药物配对,以使肿瘤对免疫攻击更敏感。此外,人们对旨在增强免疫系统识别和摧毁癌细胞的能力的尖端疗法越来越感兴趣。这些包括双特异性T细胞接合体、嵌合抗原受体T细胞、肿瘤浸润淋巴细胞、溶瘤病毒和癌症疫苗。虽然它们在NENs中的有效性仍在研究中,但这些方法具有相当大的前景,为患有这种具有挑战性和复杂性的癌症类型的患者提供了新的希望。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evolving Immunotherapy Strategies in Gastrointestinal Neuroendocrine Neoplasms.

Opinion statement: Treatment for neuroendocrine neoplasms (NENs) is tailored to the tumor's site of origin, grade, and differentiation. NENs are categorized into two main types: well-differentiated neuroendocrine tumors (NETs), which tend to grow more slowly and are less aggressive, and poorly differentiated neuroendocrine carcinomas (NECs), which are highly aggressive and harder to treat. Treatment options for NETs range from somatostatin analogues and mTOR inhibitors to peptide receptor radionuclide therapy (PRRT) with Lutetium-177 dotatate. In cases where the disease progresses more rapidly, cytotoxic chemotherapy may also be considered. In contrast, chemotherapy plays a central role in treating NECs, often following protocols similar to those used for small cell lung cancer. Exciting progress is being made in the development of new therapies for NENs. Inspired by the success of immunotherapy in other cancers, clinical trials have begun to explore its potential in NENs. Early findings suggest that immune checkpoint inhibitors (ICIs) may offer benefits, especially in patients with higher-grade NETs and NECs. However, because NENs have an immunologically "cold" tumor microenvironment-meaning they are less likely to trigger an immune response-new strategies are needed to boost ICI efficacy. To overcome this challenge, researchers are exploring innovative approaches, such as combining dual ICIs or pairing ICIs with other therapeutic agents to make the tumors more responsive to immune attack. Moreover, there is growing enthusiasm for cutting-edge therapies designed to enhance the immune system's ability to recognize and destroy cancer cells. These include bispecific T cell engagers, chimeric antigen receptor T cells, tumor-infiltrating lymphocytes, oncolytic viruses, and cancer vaccines. While their effectiveness in NENs is still being studied, these approaches hold considerable promise, offering new hope for patients with this challenging and complex cancer type.

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来源期刊
CiteScore
7.10
自引率
0.00%
发文量
113
审稿时长
>12 weeks
期刊介绍: This journal aims to review the most important, recently published treatment option advances in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to cancer treatment. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endocrine tumors, lymphomas, neuro-oncology, and cancers of the breast, head and neck, lung, skin, gastrointestinal tract, and genitourinary region. 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. We also provide commentaries from well-known oncologists, and 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.
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