浏览全部资源
扫码关注微信
免疫治疗在胃癌的围手术期及转化治疗中的应用和挑战
Application and challenge of immunotherapy in perioperative therapy of gastric cancer
- 中国癌症杂志 2024年34卷第3期 页码：259-267
- 作者机构：
中国医科大学附属第一医院胃肠肿瘤外科，辽宁 沈阳 110001
- 作者简介：
[ "薛驰（ORCID: 0000-0002-4428-7387），硕士。" ]
[ "王振宁，中国医科大学党委副书记、校长，二级教授，主任医师，博士研究生导师，国家卫生计生委突出贡献中青年专家，科技部创新人才推进计划中青年科技创新领军人才，百千万人才工程国家级人选突出贡献中青年专家，享受国务院政府特殊津贴。多年来一直致力于肿瘤诊治工作，每年完成胃肠癌手术400余台。擅长胃肠肿瘤的开放及腔镜手术，包括腹腔镜低位、超低位直肠癌保肛手术和腹腔镜胃癌根治术等。深入开展胃肠肿瘤的基础和临床研究，发现多种与胃肠癌发生、发展密切相关的非编码RNA及其调控肿瘤细胞增殖、侵袭和转移的分子机制；首次提出CLDN4基因在胃癌中的表达和功能受到非编码RNA调控网络的调节；提出完善胃肠癌临床TNM分期的新方法，指导个体化综合治疗方案的制订，相关研究成果被第8版TNM分期引用。发表学术论文319篇，其中在SCI收录期刊上发表193篇。获国家科技进步二等奖1项、省部级科技进步一等奖3项、二等奖4项、三等奖3项。获国家知识产权局授权专利3项。兼任中华医学会肿瘤学分会秘书长、中华医学会肿瘤学分会胃肠肿瘤学组组长、中华医学会外科学分会结直肠外科学组委员等学术职务。" ]
- 基金信息：
DOI：10.19401/j.cnki.1007-3639.2024.03.003
中图分类号： R735.2收稿：2024-02-27，
修回：2024-03-13，
纸质出版：2024-03-30
- 稿件说明：
移动端阅览
薛驰, 高鹏, 朱志, 等. 免疫治疗在胃癌的围手术期及转化治疗中的应用和挑战[J]. 中国癌症杂志, 2024,34(3):259-267.
Chi XUE, Peng GAO, Zhi ZHU, et al. Application and challenge of immunotherapy in perioperative therapy of gastric cancer[J]. China Oncology, 2024, 34(3): 259-267.
薛驰, 高鹏, 朱志, 等. 免疫治疗在胃癌的围手术期及转化治疗中的应用和挑战[J]. 中国癌症杂志, 2024,34(3):259-267. DOI： 10.19401/j.cnki.1007-3639.2024.03.003.
Chi XUE, Peng GAO, Zhi ZHU, et al. Application and challenge of immunotherapy in perioperative therapy of gastric cancer[J]. China Oncology, 2024, 34(3): 259-267. DOI： 10.19401/j.cnki.1007-3639.2024.03.003.
摘要
胃癌是中国常见的消化系统恶性肿瘤之一，进展期及晚期患者占比高，围手术期治疗方案的选择始终是临床上的难点。对多数局部进展期胃癌，围手术期治疗模式相较于标准根治术联合术后辅助化疗的模式，也许可以进一步改善患者生存，但传统化疗方案的疗效已达到平台期，传统分子靶向治疗进展相对缓慢，近年来，随着免疫治疗在晚期胃癌治疗中的地位不断提升，越来越多的临床研究表明，免疫治疗在围手术期胃癌患者中也可以取得较好的疗效。本文就近年来免疫治疗在胃癌围手术期中应用的研究进展进行述评。
Abstract
Gastric cancer is one of the common malignant tumors of digestive system in our country. The proportion of patients in advanced and late stage is large
and the choice of perioperative treatment program is always difficult in clinic. For most locally advanced gastric cancer
compared with standard radical surgery combined with postoperative adjuvant chemotherapy
perioperative treatment mode may further improve the survival of patients. However
the efficacy of conventional chemotherapy regimen has reached a plateau
while the progress of traditional molecular targeted therapy is relatively slow. In recent years
with the increasing role of immunotherapy in the treatment of advanced gastric cancer
more and more clinical studies have shown that immunotherapy can also achieve better efficacy in perioperative gastric cancer patients. This article reviewed the research progress of immunotherapy in perioperative gastric cancer in recent years.
关键词
Keywords
references
KANG Y K , BOKU N , SATOH T , et al . Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): a randomised, double-blind, placebo-controlled, phase 3 trial [J ] . Lancet , 2017 , 390 ( 10111 ): 2461 - 2471 . DOI: 10.1016/S0140-6736(17)31827-5 http://doi.org/10.1016/S0140-6736(17)31827-5 https://linkinghub.elsevier.com/retrieve/pii/S0140673617318275 https://linkinghub.elsevier.com/retrieve/pii/S0140673617318275
JANJIGIAN Y Y , BENDELL J , CALVO E , et al . CheckMate-032 study: efficacy and safety of nivolumab and nivolumab plus ipilimumab in patients with metastatic esophagogastric cancer [J ] . J Clin Oncol , 2018 , 36 ( 28 ): 2836 - 2844 . DOI: 10.1200/JCO.2017.76.6212 http://doi.org/10.1200/JCO.2017.76.6212
SHITARA K , AJANI J A , MOEHLER M , et al . Nivolumab plus chemotherapy or ipilimumab in gastro-oesophageal cancer [J ] . Nature , 2022 , 603 ( 7903 ): 942 - 948 . DOI: 10.1038/s41586-022-04508-4 http://doi.org/10.1038/s41586-022-04508-4
KANG Y K , CHEN L T , RYU M H , et al . Nivolumab plus chemotherapy versus placebo plus chemotherapy in patients with HER2-negative, untreated, unresectable advanced or recurrent gastric or gastro-oesophageal junction cancer (ATTRACTION-4): a randomised, multicentre, double-blind, placebo-controlled, phase 3 trial [J ] . Lancet Oncol , 2022 , 23 ( 2 ): 234 - 247 . DOI: 10.1016/S1470-2045(21)00692-6 http://doi.org/10.1016/S1470-2045(21)00692-6 https://linkinghub.elsevier.com/retrieve/pii/S1470204521006926 https://linkinghub.elsevier.com/retrieve/pii/S1470204521006926
JANJIGIAN Y Y , SHITARA K , MOEHLER M , et al . First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial [J ] . Lancet , 2021 , 398 ( 10294 ): 27 - 40 . DOI: 10.1016/S0140-6736(21)00797-2 http://doi.org/10.1016/S0140-6736(21)00797-2
SHITARA K , VAN CUTSEM E , BANG Y J , et al . Efficacy and safety of pembrolizumab or pembrolizumab plus chemotherapy vs chemotherapy alone for patients with first-line, advanced gastric cancer: the KEYNOTE-062 phase 3 randomized clinical trial [J ] . JAMA Oncol , 2020 , 6 ( 10 ): 1571 - 1580 . DOI: 10.1001/jamaoncol.2020.3370 http://doi.org/10.1001/jamaoncol.2020.3370 https://jamanetwork.com/journals/jamaoncology/fullarticle/2769922 https://jamanetwork.com/journals/jamaoncology/fullarticle/2769922
HUANG J , MO H N , ZHANG W L , et al . Promising efficacy of SHR-1210, a novel anti-programmed cell death 1 antibody, in patients with advanced gastric and gastroesophageal junction cancer in China [J ] . Cancer , 2019 , 125 ( 5 ): 742 - 749 . DOI: 10.1002/cncr.31855 http://doi.org/10.1002/cncr.31855
XU J M , JIANG H P , PAN Y Y , et al . Sintilimab plus chemotherapy for unresectable gastric or gastroesophageal junction cancer: the ORIENT-16 randomized clinical trial [J ] . JAMA , 2023 , 330 ( 21 ): 2064 - 2074 . DOI: 10.1001/jama.2023.19918 http://doi.org/10.1001/jama.2023.19918
MURO K , VAN CUTSEM E , NARITA Y , et al . Pan-Asian adapted ESMO clinical practice guidelines for the management of patients with metastatic gastric cancer: a JSMO-ESMO initiative endorsed by CSCO, KSMO, MOS, SSO and TOS [J ] . Ann Oncol , 2019 , 30 ( 1 ): 19 - 33 . DOI: S0923-7534(19)31003-8 http://doi.org/S0923-7534(19)31003-8
WANG F H , ZHANG X T , LI Y F , et al . The Chinese Society of Clinical Oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer, 2021 [J ] . Cancer Commun , 2021 , 41 ( 8 ): 747 - 795 . DOI: 10.1002/cac2.v41.8 http://doi.org/10.1002/cac2.v41.8 https://onlinelibrary.wiley.com/toc/25233548/41/8 https://onlinelibrary.wiley.com/toc/25233548/41/8
MOEHLER M H , KATO K , ARKENAU H T , et al . Rationale 305: phase 3 study of tislelizumab plus chemotherapy vs placebo plus chemotherapy as first-line treatment (1L) of advanced gastric or gastroesophageal junction adenocarcinoma (GC/GEJC) [J ] . 2023 , 41 ( 4_suppl ): 286.
HASEGAWA H , SHITARA K , TAKIGUCHI S , et al . A multicenter, open-label, single-arm phase Ⅰ trial of neoadjuvant nivolumab monotherapy for resectable gastric cancer [J ] . Gastric Cancer , 2022 , 25 ( 3 ): 619 - 628 . DOI: 10.1007/s10120-022-01286-w http://doi.org/10.1007/s10120-022-01286-w
ANDRÉ T , TOUGERON D , PIESSEN G , et al . Neoadjuvant nivolumab plus ipilimumab and adjuvant nivolumab in localized deficient mismatch repair/microsatellite instability-high gastric or esophagogastric junction adenocarcinoma: the GERCOR NEONIPIGA phase Ⅱ study [J ] . J Clin Oncol , 2023 , 41 ( 2 ): 255 - 265 .
VERSCHOOR Y L , VAN DE HAAR J , VAN DEN BERG J G , et al . Neoadjuvant atezolizumab plus chemotherapy in gastric and gastroesophageal junction adenocarcinoma: the phase 2 PANDA trial [J ] . Nat Med , 2024 , 30 ( 2 ): 519 - 530 . DOI: 10.1038/s41591-023-02758-x http://doi.org/10.1038/s41591-023-02758-x
PIETRANTONIO F , RAIMONDI A , LONARDI S , et al . INFINITY: a multicentre, single-arm, multi-cohort, phase Ⅱ trial of tremelimumab and durvalumab as neoadjuvant treatment of patients with microsatellite instability-high (MSI) resectable gastric or gastroesophageal junction adenocarcinoma (GAC/GEJAC) [J ] . J Clin Oncol , 2023 , 41 ( 4_suppl ): 358.
TERASHIMA M , IWASAKI Y , MIZUSAWA J , et al . Randomized phase Ⅲ trial of gastrectomy with or without neoadjuvant S-1 plus cisplatin for type 4 or large type 3 gastric cancer, the short-term safety and surgical results: Japan Clinical Oncology Group Study (JCOG0501) [J ] . Gastric Cancer , 2019 , 22 ( 5 ): 1044 - 1052 . DOI: 10.1007/s10120-019-00941-z http://doi.org/10.1007/s10120-019-00941-z
CUNNINGHAM D , ALLUM W H , STENNING S P , et al . Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J ] . N Engl J Med , 2006 , 355 ( 1 ): 11 - 20 . DOI: 10.1056/NEJMoa055531 http://doi.org/10.1056/NEJMoa055531 http://www.nejm.org/doi/abs/10.1056/NEJMoa055531 http://www.nejm.org/doi/abs/10.1056/NEJMoa055531
YCHOU M , BOIGE V , PIGNON J P , et al . Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase Ⅲ trial [J ] . J Clin Oncol , 2011 , 29 ( 13 ): 1715 - 1721 .
KANG Y K , YOOK J H , PARK Y K , et al . Phase Ⅲ randomized study of neoadjuvant chemotherapy (CT) with docetaxel(D), oxaliplatin(O) and S-1(S) (DOS) followed by surgery and adjuvant S-1, vs surgery and adjuvant S-1, for resectable advanced gastric cancer (GC) (PRODIGY) [J ] . Ann Oncol , 2019 , 30 : v876 -v877.
AL-BATRAN S E , HOMANN N , PAULIGK C , et al . Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial [J ] . Lancet , 2019 , 393 ( 10184 ): 1948 - 1957 . DOI: 10.1016/S0140-6736(18)32557-1 http://doi.org/10.1016/S0140-6736(18)32557-1 https://linkinghub.elsevier.com/retrieve/pii/S0140673618325571 https://linkinghub.elsevier.com/retrieve/pii/S0140673618325571
WANG X X , LI S , XIE T Y , et al . Early results of the randomized, multicenter, controlled evaluation of S-1 and oxaliplatin as neoadjuvant chemotherapy for Chinese advanced gastric cancer patients (RESONANCE trial) [J ] . J Clin Oncol , 2020 , 38 ( 4_suppl ): 280.
YUAN S Q , NIE R C , JIN Y , et al . Author correction: perioperative toripalimab and chemotherapy in locally advanced gastric or gastro-esophageal junction cancer: a randomized phase 2 trial [J ] . Nat Med , 2024 , 30 ( 2 ): 605.
AL-BATRAN S E , LORENZEN S , THUSS-PATIENCE P C , et al . Surgical and pathological outcome, and pathological regression, in patients receiving perioperative atezolizumab in combination with FLOT chemotherapy versus FLOT alone for resectable esophagogastric adenocarcinoma: interim results from DANTE, a randomized, multicenter, phase Ⅱb trial of the FLOT-AIO German Gastric Cancer Group and Swiss SAKK [J ] . J Clin Oncol , 2022 , 40 ( 16_suppl ): 4003.
SHITARA K , RHA S Y , WYRWICZ L S , et al . Neoadjuvant and adjuvant pembrolizumab plus chemotherapy in locally advanced gastric or gastro-oesophageal cancer (KEYNOTE-585): an interim analysis of the multicentre, double-blind, randomised phase 3 study [J ] . Lancet Oncol , 2024 , 25 ( 2 ): 212 - 224 . DOI: 10.1016/S1470-2045(23)00541-7 http://doi.org/10.1016/S1470-2045(23)00541-7
RHA S Y , OH D Y , YAÑEZ P , et al . Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric cancer (KEYNOTE-859): a multicentre, randomised, double-blind, phase 3 trial [J ] . Lancet Oncol , 2023 , 24 ( 11 ): 1181 - 1195 . DOI: 10.1016/S1470-2045(23)00515-6 http://doi.org/10.1016/S1470-2045(23)00515-6 https://linkinghub.elsevier.com/retrieve/pii/S1470204523005156 https://linkinghub.elsevier.com/retrieve/pii/S1470204523005156
ZHANG X , WANG J , WANG G , et al . LBA79 GEMSTONE-303: prespecified progression-free survival (PFS) and overall survival (OS) final analyses of a phase Ⅲ study of sugemalimab plus chemotherapy vs placebo plus chemotherapy in treatment-naïve advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma [J ] . Ann Oncol , 2023 , 34 : S1319 . DOI: 10.1016/j.annonc.2023.10.080 http://doi.org/10.1016/j.annonc.2023.10.080 https://linkinghub.elsevier.com/retrieve/pii/S0923753423042242 https://linkinghub.elsevier.com/retrieve/pii/S0923753423042242
JANJIGIAN Y Y , KAWAZOE A , YAÑEZ P , et al . The KEYNOTE-811 trial of dual PD-1 and HER2 blockade in HER2-positive gastric cancer [J ] . Nature , 2021 , 600 ( 7890 ): 727 - 730 . DOI: 10.1038/s41586-021-04161-3 http://doi.org/10.1038/s41586-021-04161-3
SATOH T , KANG Y K , CHAO Y E , et al . Exploratory subgroup analysis of patients with prior trastuzumab use in the ATTRACTION-2 trial: a randomized phase Ⅲ clinical trial investigating the efficacy and safety of nivolumab in patients with advanced gastric/gastroesophageal junction cancer [J ] . Gastric Cancer , 2020 , 23 ( 1 ): 143 - 153 . DOI: 10.1007/s10120-019-00970-8 http://doi.org/10.1007/s10120-019-00970-8
JANJIGIAN Y Y , KAWAZOE A , BAI Y , et al . Pembrolizumab plus trastuzumab and chemotherapy for HER2-positive gastric or gastro-oesophageal junction adenocarcinoma: interim analyses from the phase 3 KEYNOTE-811 randomised placebo-controlled trial [J ] . Lancet , 2023 , 402 ( 10418 ): 2197 - 2208 . DOI: 10.1016/S0140-6736(23)02033-0 http://doi.org/10.1016/S0140-6736(23)02033-0
LEE K W , BAI L Y , JUNG M , et al . 1518P Zanidatamab (zani) plus chemotherapy (chemo) and tislelizumab (tis) as first-line (1l) therapy for patients (pts) with advanced HER2-positive (+) gastric/gastroesophageal junction adenocarcinoma (GC/GEJC): updated results from a phase Ⅰb/Ⅱ study [J ] . Ann Oncol , 2023 , 34 : S855 -S856.
ZHU L J , LI S , BAO J , et al . First-line of camrelizumab plus pyrotinib and chemotherapy in HER2-positive advanced gastric or gastroesophageal junction adenocarcinoma: a dose escalation and expansion phase Ⅰ study [J ] . J Clin Oncol , 2023 , 41 ( 4_suppl ): 356.
KAWAKAMI H , HIRONAKA S , ESAKI T , et al . An investigator-initiated phase 2 study of nivolumab plus low-dose ipilimumab as first-line therapy for microsatellite instability-high advanced gastric or esophagogastric junction cancer (NO LIMIT, WJOG13320G/CA209-7W7) [J ] . Cancers , 2021 , 13 ( 4 ): 805.
KIM S T , CRISTESCU R , BASS A J , et al . Comprehensive molecular characterization of clinical responses to PD-1 inhibition in metastatic gastric cancer [J ] . Nat Med , 2018 , 24 ( 9 ): 1449 - 1458 . DOI: 10.1038/s41591-018-0101-z http://doi.org/10.1038/s41591-018-0101-z
0
浏览量
2677
下载量
0
CSCD
- 网络PDF下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
AI问答- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies