Abstract:
UNASSIGNED: Biliary tract cancer (BTC) is a heterogeneous group of aggressive malignancies that arise from the epithelium of the biliary tract. Most patients present with locally advanced or metastatic disease at the time of diagnosis. For patients with unresectable BTC, the survival advantage provided by systemic chemotherapy was limited. Over the last decade, immunotherapy has significantly improved the therapeutic landscape of solid tumors. There is an increasing number of studies evaluating the application of immunotherapy in BTC, including immune checkpoint inhibitors (ICIs), cancer vaccines and adoptive cell therapy. The limited response to ICIs monotherapy in unselected patients prompted investigators to explore different combination therapy strategies. Early clinical trials of therapeutic cancer vaccination and adoptive cell therapy have shown encouraging clinical results. However, there still has been a long way to go via validation of therapeutic efficacy and exploration of strategies to increase the efficacy. Identifying biomarkers that predict the response to immunotherapy will allow a more accurate selection of candidates. This review will provide an up-to-date overview of the current clinical data on the role of immunotherapy, summarize the promising biomarkers predictive of the response to ICIs and discuss the perspective for future research direction of immunotherapy in advanced BTC.
摘要:
■胆道癌(BTC)是一组异质性的侵袭性恶性肿瘤,起源于胆道上皮。大多数患者在诊断时出现局部晚期或转移性疾病。对于不可切除的BTC患者,全身化疗提供的生存优势有限.在过去的十年里,免疫治疗显著改善了实体肿瘤的治疗前景。越来越多的研究评估免疫治疗在BTC中的应用,包括免疫检查点抑制剂(ICIs),癌症疫苗和过继细胞疗法。未经选择的患者对ICIs单药治疗的反应有限,促使研究人员探索不同的联合治疗策略。治疗性癌症疫苗接种和过继细胞疗法的早期临床试验已经显示出令人鼓舞的临床结果。然而,验证治疗效果和探索提高疗效的策略还有很长的路要走.识别预测免疫疗法反应的生物标志物将允许更准确地选择候选物。这篇综述将提供关于免疫治疗作用的当前临床数据的最新概述。总结了预测ICIs反应的有前景的生物标志物,并讨论了未来在先进BTC中免疫治疗的研究方向。