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Review Article

免疫检查点抑制剂在结直肠癌治疗中的出现

卷 22, 期 9, 2021

发表于: 04 February, 2021

页: [1021 - 1033] 页: 13

弟呕挨: 10.2174/1389450122666210204204415

价格: $65

摘要

免疫疗法已经彻底改变了许多实体瘤的治疗方式。在结直肠癌中，证据表明，由于新抗原负荷增加和有利的肿瘤微环境，微卫星高(MSI-H)肿瘤对免疫检查点阻断最敏感。事实上，Pembrolizumab现在是这类患者的一线选择。然而，MSI-H肿瘤代表少数和一部分患者的进展，尽管最初有所反应。试验正在研究不同的免疫治疗组合策略，以增强免疫原性较低的结直肠肿瘤的免疫反应。这种策略包括双重免疫检查点阻断，将免疫检查点抑制剂与其他治疗方式如放疗、化疗或其他生物或靶向制剂相结合。此外，越来越多的人开始识别生物标志物，以更好地选择最有可能对免疫疗法产生反应的患者，并了解内在和获得性耐药机制。除了MSI-H肿瘤之外，有充分的理由表明，具有DNA聚合酶ε和DNA聚合酶δ变化的肿瘤也可能对免疫治疗有反应，并且在该亚群中的试验正在进行中。其他策略，如用烷化剂引发O6-甲基鸟嘌呤脱氧核糖核酸甲基转移酶沉默的肿瘤，使其接受免疫检查点阻断，也在研究中。在这里，我们讨论了不同的结肠直肠亚群及其对免疫检查点阻断反应的可能性，以及克服成功临床结果障碍的策略。我们总结了已发表的临床试验的证据，并概述了正在进行的试验，同时讨论了新的免疫治疗策略，如过继细胞疗法和癌症疫苗。

关键词: 结直肠癌，免疫疗法，免疫检查点抑制剂，微卫星稳定，过继细胞疗法，癌症疫苗。

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