Abstract:
In recent years, immune checkpoint inhibitors (ICIs) have been widely used in malignant solid tumors with remarkable efficacy. However, in colorectal cancer (CRC), ICIs have shown significant therapeutic effects only in patients with highly microsatellite unstable/mismatch repair-deficient metastatic CRC and these patients are only a minority of all CRC patients. In contrast, the majority of patients, those with microsatellite stable (MSS)/mismatch repair-complete (pMMR)-type metastatic CRC, could hardly benefit from ICI monotherapies, and immune combination therapies have become the key to solveing this clinical challenge. This article introduces the common patterns and possible mechanisms of immune-combination therapies for MSS/pMMR-type CRC, the exploration and progress made in the application of immune-combination therapies, as well as the possible predictive markers of efficacy of immune therapies. The prospects and directions of ICIs in the treatment of MSS/pMMR-type CRC are also discussed.
近年来,免疫检查点抑制剂(ICIs)在恶性实体肿瘤中应用广泛且疗效显著。然而,在结直肠癌(CRC)中,ICIs仅对占少数的微卫星高度不稳定/错配修复缺失型转移性CRC表现出显著的治疗效果,而占大多数的微卫星稳定(MSS)/错配修复完整(pMMR)型转移性CRC几乎不能从ICIs单药治疗中获益,免疫联合治疗成为破解这一临床难题的关键。文章介绍了MSS/pMMR型CRC免疫联合治疗的常见模式和可能机制,总结归纳了MSS/pMMR型CRC免疫联合治疗方面所做的探索和取得的进展以及免疫治疗疗效的可能预测标志物,对ICIs在MSS/pMMR型CRC治疗中的应用前景进行了展望。.