免疫检查点抑制剂治疗结直肠癌的临床试验梳理  

Immune checkpoint inhibitors in the treatment of colorectal cancer:a review of clinical trials

作　　者：公小蕾 赵林[1] Gong Xiaolei;Zhao Lin(Department of Oncology,Peking Union Medical College Hospital,Beijing 100032,China)

机构地区：[1]北京协和医院肿瘤内科,北京100730

出　　处：《中华胃肠外科杂志》2022年第3期205-213,共9页Chinese Journal of Gastrointestinal Surgery

摘　　要：结直肠癌是全球第三大肿瘤,治疗手段包括手术、化疗、放疗和靶向治疗等。免疫检查点抑制剂的出现改写了许多瘤种的诊治指南。免疫检查点抑制剂在不同微卫星状态结直肠癌中有着显著的疗效差别,微卫星高度不稳定(MSI-H)结直肠癌无论是在后线、一线、辅助还是新辅助治疗方面,均取得了突破。KEYNOTE-177研究已经成功地改写了指南,帕博利珠单抗成为一线MSI-H晚期结直肠癌的标准治疗。NICHE研究将免疫治疗用于结直肠癌的新辅助治疗,在MSI-H结直肠癌中也取得了令人振奋的成绩。而对于微卫星稳定(MSS)结直肠癌,许多研究正在进行,免疫治疗尚不能挑战传统治疗的地位。本文就免疫检查点抑制剂治疗结直肠癌的相关临床研究进行梳理,期望为结直肠癌免疫治疗的发展提供参考。Colorectal cancer is the third most common cancer in the world.The treatments include surgery,chemotherapy,radiotherapy and targeted therapy.The guidelines of many tumor types have been rewritten with the advent of immune checkpoint inhibitors.There are significant differences in the efficacy of immune checkpoint inhibitors in colorectal cancer according to microsatellite status.Microsatellite instability-high(MSI-H)colorectal cancer has made a breakthrough in immunotherapy,whether in the late-line,first-line,adjuvant or neoadjuvant therapy.The success of KEYNOTE-177 study has changed the guidelines with pembrolizumab becoming a standard treatment in the first-line treatment of MSI-H advanced colorectal cancer.The NICHE study,which used immunotherapy as neoadjuvant treatment of colorectal cancer,has made exciting achievements in MSI-H colorectal cancer.For microsatellite stability(MSS)colorectal cancer,many studies are ongoing,and immunotherapy is still unable to challenge the status of traditional treatment.In this paper,we review the clinical trials related to immune checkpoint inhibitors of colorectal cancer,expecting to provide references for the development of colorectal cancer immunotherapy.

关 键 词：结直肠癌 免疫检查点抑制剂 临床试验 

分 类 号：R735.34[医药卫生—肿瘤]