摘要
免疫检查点抑制剂改变了具有微卫星不稳定的转移性结直肠癌患者的治疗格局,让这部分晚期肠癌患者获得了较常规治疗更高的缓解率及更长的生存时间。但是微卫星不稳定型肿瘤在转移性结直肠癌中仅占到了约5%,而免疫检查点抑制剂对约占95%的微卫星稳定型肿瘤疗效甚微。我们回顾了转移性结直肠癌患者的免疫学特征及免疫检查点抑制剂在微卫星不稳定型转移性结直肠癌患者中的疗效和存在问题,以及在微卫星稳定型转移性结直肠癌中较差的免疫反应性和目前联合治疗探索结果,并进一步总结潜在可以有效筛选免疫检查点抑制剂治疗获益人群的标志物,分析并展望未来免疫相关治疗的机制探索及疗效预测等问题,期望为更多的转移性结直肠癌患者提供有效的免疫治疗方案。
Immune checkpoint inhibitors(ICIs)have changed the treatment pattern in patients with microsatellite instability(MSI)metastatic colorectal cancer(mCRC),and made these patients obtain a higher remission rate and longer overall survival than conventional treatment.However,MSI tumors account for only about 5%of mCRC patients,while ICIs have little effect on about 95%of microsatellite stable tumors.Therefore,we review the immunological characteristics of mCRC patients,the efficacy and problems of ICIs in mCRC patients with MSI,as well as the poor immune reactivity and current results of combination therapy in mCRC patients with microsatellite stability(MSS),summarize the potential markers that can effectively screen the population benefiting from ICI treatment,and analyze the mechanism exploration and efficacy prediction of immune related therapy in the future,hoping to provide effective immunotherapy for more mCRC patients.
作者
张兰
李胜棉
Zhang Lan;Li Shengmian(Department of Gastroenterology,the Fourth Hospital of Hebei Medical University,Shijiazhuang,050000,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2021年第11期805-813,共9页
Chinese Journal of Clinicians(Electronic Edition)
作者简介
通信作者:李胜棉,Email:shengmianli2013@163.com
