期刊
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
卷 173, 期 -, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2022.103663
关键词
Metastatic colorectal cancer; Immune-checkpoint inhibitors; Anti-PD-1/PD-L1; Anti-CTLA4; Immunotherapy; Deficient MMR/microsatellite instability-high (dMMR/MSI-H); Mismatch repair-proficient/microsatellite stable (pMMR/MSS)
Immune-checkpoint inhibitors have shown potential in the treatment of metastatic colorectal cancer. Pembrolizumab is approved as a preferred option in first-line treatment, while nivolumab alone or in combination with ipilimumab is an alternative option. In subsequent lines, these immunotherapeutic regimens, as well as dostarlimab-gxly, are recommended for chemo-resistant mCRC patients who have not received ICIs previously.
The long-term remissions induced by immune-checkpoint inhibitors (ICIs) in many types of cancers have opened up the possibility of a broader use of immunotherapy in less immunogenic but genetically heterogeneous tumours. Regarding metastatic colorectal cancer (mCRC), in first-line setting, pembrolizumab has been approved as preferred option and nivolumab, alone or in combination with ipilimumab as alternative option for patients with mismatch-repair-deficient and microsatellite instability-high (dMMR/MSI-H) disease, independently of their eligibility for intensive chemotherapy. In subsequent lines, both these immunotherapeutic regimens (e.g., pembrolizumab and nivolumab+/-ipilimumab) as well as dostarlimab-gxly are currently recommended for patients with dMMR/MSI-H chemo-resistant mCRC who have not previously received an ICI. Beginning from the rationale behind the immune-mediated interplay in the dMMR/MSI-H bowel microenvironment, we provide here an update on the evolution status of all available, approved or not, ICIs in mCRC, describing their efficacy and toxicity profile with an emphasis on the pivotal trials supporting current colorectal indications. For each ICI agent, the results from combinations under investigation, particularly for those being upgraded in clinical phasing, the perspectives but also the limitations of main ongoing trials are thoroughly discussed. In the close future, upcoming data are expected to confirm the clinical benefit of ICIs and to further expand their role in mCRC.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据