PDF(Pubmed)
Abstract：
Immunotherapy with PD-1 blockade has achieved a great success in colorectal cancers (CRCs) with high microsatellite instability (MSI-H) and deficient mismatch repair (dMMR), and has become the first-line therapy in metastatic setting. Studies of neoadjuvant immunotherapy also report exciting results, showing high rates of clinical complete response (cCR) and pathological complete response. The high efficacy and long duration of response of immunotherapy has prompt attempts to adopt watch-and-wait strategy for patients achieving cCR following the treatment. Thankfully, the watch-and-wait approach has been proposed for nearly 20 years for patients undergoing chemoradiotherapy and has gained ground among patients as well as clinicians. In this narrative review, we combed through the available information on immunotherapy for CRC and on the watch-and-wait strategy in chemoradiotherapy, and looked forward to a future where neoadjuvant immunotherapy as a curative therapy would play a big part in the treatment of MSI-H/dMMR CRC.
摘要：
PD-1阻断的免疫治疗在具有高微卫星不稳定性（MSI-H）和缺陷错配修复（dMMR）的结直肠癌（CRC）中取得了巨大的成功，并已成为转移背景下的一线治疗。新辅助免疫疗法的研究也报告了令人兴奋的结果，临床完全缓解（cCR）和病理完全缓解率较高。免疫疗法的高疗效和长持续时间的反应促使人们尝试对治疗后实现cCR的患者采取观察和等待策略。谢天谢地,观察和等待方法已被提出近20年的放化疗患者，并已在患者和临床医生中取得了进展。在这篇叙述性评论中，我们梳理了有关CRC的免疫治疗和放化疗中的观察和等待策略的现有信息，并期待未来新辅助免疫疗法作为治愈性治疗将在MSI-H/dMMRCRC的治疗中发挥重要作用。
