PDF(Pubmed)
Abstract：
Despite advances in treatment strategies and surgical approaches in recent years, improving survival outcomes in esophagogastric cancer (EGC) patients treated with curative intent remains a significant area of unmet need. The recent emergence of adjuvant immunotherapy as the standard of care for resected EGC demonstrates the impact of immunotherapy in improving recurrence-free survival. Neoadjuvant and perioperative immunotherapies represent another promising approach with potential advantages over adjuvant therapy. Despite the promising results of early neoadjuvant immunotherapy studies, there are several challenges and future research needs. The optimal timing, duration and number of doses in relation to surgery and the optimal combination of immunotherapies are still unclear. In addition, rigorous correlative studies need to be performed to identify biomarkers for patient selection and treatment response prediction to maximize the benefits of neoadjuvant immunotherapy. In this review, we provide a concise summary of the current standard of care for resectable EGC and discuss the rationale for the use of immune checkpoint inhibitors in this setting and the pre-clinical and early clinical data of these novel therapies. Finally, we will examine the potential role and future direction of immunotherapy in the treatment paradigm and the perceived challenges and opportunities that lay ahead.
摘要：
尽管近年来在治疗策略和手术方法方面取得了进展，在接受根治性治疗的食管胃癌(EGC)患者中,改善生存结局仍然是未满足需求的重要领域.最近出现的辅助免疫疗法作为切除的EGC的护理标准证明了免疫疗法在改善无复发生存率方面的影响。新辅助和围手术期免疫疗法代表了另一种有希望的方法，与辅助疗法相比具有潜在的优势。尽管早期新辅助免疫疗法研究取得了有希望的结果，有几个挑战和未来的研究需求。最佳时机,与手术相关的持续时间和剂量数量以及免疫疗法的最佳组合仍不清楚.此外,需要进行严格的相关研究,以确定用于患者选择和治疗反应预测的生物标志物,从而最大限度地发挥新辅助免疫治疗的益处.在这次审查中,我们简要总结了目前可切除EGC的治疗标准,并讨论了在这种情况下使用免疫检查点抑制剂的理由,以及这些新疗法的临床前和早期临床数据.最后,我们将研究免疫治疗在治疗模式中的潜在作用和未来方向，以及未来的挑战和机遇。
