新辅助免疫治疗在局部进展期胃癌外科治疗的应用现状与挑战  

Application and challenge of neoadjuvant immunotherapy on perioperative treatment for locally advanced gastric cancer

作　　者：崔昊 张珂诚 卫勃 陈凛[1,2] Cui Hao;Zhang Kecheng;Wei Bo;Chen Lin(School of Medicine,Nankai University,Tianjin 300071,China;Department of General Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]南开大学医学院,天津300071 [2]解放军总医院第一医学中心普通外科医学部,北京100853

出　　处：《国际外科学杂志》2023年第5期289-294,共6页International Journal of Surgery

基　　金：国家自然科学基金(82073192、82273231、82103593);北京市科技计划项目(Z221100007422125)。

摘　　要：免疫治疗在进展期胃癌中的应用已成为目前的研究热点。与此同时,免疫治疗与术前新辅助治疗模式的有机融合有望进一步实现肿瘤降期、病理缓解、根治切除,提升局部进展期胃癌的整体治疗效果。然而,新辅助免疫治疗是否影响局部进展期胃癌患者围手术期并发症、不良事件、肿瘤病理学响应、远期生存等仍处于临床初期的探索阶段,有赖于开展大样本、前瞻性Ⅲ期临床研究来探究其临床价值。此外,关注新药及新型治疗模式探索、筛选高特异性疗效预测指标、权衡新辅助治疗周期与手术时间选择,有助于优化及规范新辅助免疫治疗的合理应用,最终使患者获益。The application of immunotherapy in advanced gastric cancer has become a research hotspot.At the same time,the combination of immunotherapy and neoadjuvant therapy is expected to further achieve tumor downstage,pathological remission,increase the proportion of R0 resection,which enhance the overall therapeutic effect of locally advanced gastric cancer(LAGC).Whether neoadjuvant immunotherapy affects perioperative complications,adverse events,tumor pathological responses,and long-term survival in LAGC is still in the initial stage of clinical exploration,which depends on large-scale prospective phase III clinical studies to demonstrate its clinical value.Meanwhile,the application of new innovative drugs and comprehensive perioperative treatment,screening high-specific biomarkers for therapeutic prediction,and weighing the selection of neoadjuvant cycle and interval of treatment-operation time are helpful to optimize and standardize the rational application of neoadjuvant immunotherapy,and ultimately bring benefits to patients.

关 键 词：胃肿瘤 肿瘤辅助疗法 免疫疗法 外科 

分 类 号：R735.2[医药卫生—肿瘤]