摘要
2015年首次发现高度微卫星不稳定(microsatellite instable-high,MSI-H)/错配修复缺陷(mismatch repair deficiency,dMMR)型结直肠癌对免疫治疗敏感,开启了结直肠癌的免疫治疗时代。然而,微卫星稳定(microsatellite stable,MSS)型结直肠癌对免疫治疗并不敏感。术前新辅助放化疗是目前局部进展期直肠癌(locally advanced rectal cancer,LARC)的标准治疗方式,其临床完全缓解率为20%~30%、病理完全缓解率为5%~44%。为了提高术前新辅助同步放化疗的缓解率,提出通过联合免疫治疗以提高缓解率。2020年在2023年美国临床肿瘤学会年会上,首次展示了新辅助放化疗联合免疫治疗用于治疗MSS型直肠癌的成果。本文旨在回顾近年来MSS型局部进展期直肠癌新辅助放化疗联合免疫治疗的研究进展,并对前景进行展望。
In 2015,microsatellite instable-high(MSI-H)/mismatch repair deficiency(dMMR)type colorectal cancer was first discovered to be sensitive to immunotherapy,ushering in the era of immunotherapy for colorectal cancer.However,microsatellite stable(MSS)type colorectal cancer is not sensitive to immunotherapy.Preoperative neoadjuvant radiotherapy and chemotherapy are currently the standard treatment for locally advanced rectal cancer(LARC),with a clinical complete response rate of 20%-30%and a pathological complete response rate of 5%-44%.In order to improve the response rate of preoperative neoadjuvant synchronous radiotherapy and chemotherapy,the combined immunotherapy is suggested to be used to improve the response rate.The results released at the 2020 American Society of Clinical Oncology(ASCO)conference showed that neoadjuvant chemotherapy combined with immuno-therapy is a new research direction for MSS type rectal cancer.This review aims to summarize the research progress in neoadjuvant radiotherapy and chemotherapy combined with immunotherapy for MSS type locally advanced rectal cancer in recent years,and provide prospects for the future.
作者
马盛哲
MA Shengzhe(Department of Colorectal Surgery,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)
出处
《肿瘤》
CAS
北大核心
2023年第5期411-420,共10页
Tumor
关键词
局部进展期直肠癌
微卫星稳定型
新辅助放化疗
免疫治疗
Locally advanced rectal cancer
Microsatellite stable type
Neoadjuvant radiotherapy and chemotherapy
Immunotherapy
作者简介
Correspondence to:马盛哲,E-mail:shengzhema2017@icloud.com
