Abstract:
Colorectal cancer (CRC) continues to be one of the most prevalent and lethal cancers worldwide. Over the past decades, immune checkpoint inhibitors (ICIs) have shown to significantly improve patient outcomes in mismatch repair-deficient metastasized CRC. However, widening the scope of this novel treatment modality has been the object of growing interest. This article will review several landmark trials, while exploring various aspects of this rapidly evolving field, including potential neoadjuvant (or even entirely nonsurgical) and adjuvant indications in localized disease. We will also discuss differences between management of rectal and colon cancer, current and expected challenges (eg. resistance, toxicities, pseudoprogression, biomarkers) and other future opportunities including combinations with other therapeutic agents and the role of ICIs in the treatment of both deficient as well as proficient mismatch repair (dMMR and pMMR respectively) CRC.
摘要:
结直肠癌(CRC)仍然是全世界最普遍和最致命的癌症之一。在过去的几十年里,免疫检查点抑制剂(ICIs)已显示显著改善错配修复缺陷性转移CRC患者的预后.然而,扩大这种新颖的治疗方式的范围一直是人们越来越感兴趣的对象。本文将回顾几个具有里程碑意义的试验,在探索这个快速发展的领域的各个方面的同时,包括潜在的新辅助治疗(甚至完全非手术)和局部疾病的辅助适应症。我们还将讨论直肠癌和结肠癌之间的差异,当前和预期的挑战(例如阻力,毒性,伪进程,生物标志物)和其他未来机会,包括与其他治疗剂的组合以及ICIs在治疗缺陷性和熟练错配修复(分别为dMMR和pMMR)CRC中的作用。