免疫检查点抑制剂治疗错配修复缺陷/微卫星高度不稳定型胃癌的研究进展  

Research progress on immune checkpoint inhibitors for the treatment of mismatch repair-deficient/microsatellite instability-high gastric cancer

作　　者：刘清华 汪浩浩 陈庆杰 罗瑞英 罗长江[1] Qinghua Liu;Haohao Wang;Qingjie Chen;Ruiying Luo;Changjiang Luo(Department of General Surgery,Lanzhou University Second Hospital,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院普外科,兰州市730000

出　　处：《中国肿瘤临床》2024年第11期580-584,共5页Chinese Journal of Clinical Oncology

基　　金：甘肃省自然科学基金项目(编号:21JR1RA139);甘肃省青年科学技术基金项目(编号:21JR11RA113)资助。

摘　　要：错配修复缺陷/微卫星高度不稳定型(mismatch repair-deficient/microsatellite instability-high,dMMR/MSI-H)胃癌是胃癌的一个特殊分子亚型,其因独特的免疫微环境和高突变负荷对免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)高度敏感。ICIs治疗dMMR/MSI-H胃癌在多项临床研究中展现出较好的效果,但仍存在原发耐药与继发耐药的挑战。如何在这一特殊分子亚型的胃癌中选择合适的ICIs和克服耐药性是临床上亟需解决的问题。本文对ICIs的作用机制,及其治疗dMMR/MSI-H胃癌的研究进展和存在的耐药性挑战进行综述,以期为临床治疗提供参考。Mismatch repair-deficient/microsatellite instability-high(dMMR/MSI-H)gastric cancer represents a distinct molecular subtype of tumors characterized by pronounced sensitivity to immune checkpoint inhibitors(ICIs)attributed to its unique immune microenvironment and elevated mutation burden.Various clinical studies underscore the efficacy of ICIs in treating dMMR/MSI-H gastric cancer;however,challenges such as primary and acquired resistance persist.Overcoming resistance and identifying optimal ICIs for its treatment remain critical clinical issues.This review delineates the mechanisms of ICIs,recent advances in their therapeutic application for dMMR/MSI-H gastric cancer,and ongoing challenges in combating resistance,aiming to guide clinical practice effectively.

关 键 词：错配修复缺陷/微卫星高度不稳定型胃癌 免疫检查点抑制剂 耐药性 

分 类 号：R735.2[医药卫生—肿瘤]