دورية أكاديمية
أعرض في EDS

Immunotherapy in the neoadjuvant treatment of gastrointestinal tumors: is the time ripe?

التفاصيل البيبلوغرافية
العنوان: Immunotherapy in the neoadjuvant treatment of gastrointestinal tumors: is the time ripe?
المؤلفون: Gervaso L; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy.; Molecular Medicine Program, University of Pavia, Pavia, Lombardia, Italy., Ciardiello D; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy., Oliveira RA; Clinical Oncology, Londrina Cancer Hospital, Londrina, Paranà, Brazil., Borghesani M; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy., Guidi L; Division of New Drugs and Early Drug Development for Innovative Therapies, IEO IRCCS, European Institute of Oncology, Milano, Italy., Benini L; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy., Algeri L; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy., Spada F; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy., Zampino MG; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy., Cella CA; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy., Fazio N; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO IRCCS, European Institute of Oncology, Milano, Italy nicola.fazio@ieo.it.
المصدر: Journal for immunotherapy of cancer [J Immunother Cancer] 2024 May 23; Vol. 12 (5). Date of Electronic Publication: 2024 May 23.
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101620585 Publication Model: Electronic Cited Medium: Internet ISSN: 2051-1426 (Electronic) Linking ISSN: 20511426 NLM ISO Abbreviation: J Immunother Cancer Subsets: MEDLINE
أسماء مطبوعة: Publication: 2020- : London, United Kingdom : BMJ Publishing Group Ltd.
Original Publication: London : BioMed Central, 2013-
مواضيع طبية MeSH: Neoadjuvant Therapy*/methods , Gastrointestinal Neoplasms*/drug therapy , Gastrointestinal Neoplasms*/therapy , Immunotherapy*/methods, Humans ; Immune Checkpoint Inhibitors/therapeutic use ; Immune Checkpoint Inhibitors/pharmacology ; Microsatellite Instability
مستخلص: Immune checkpoint inhibitors (ICIs) revolutionized the management of mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) gastrointestinal (GI) cancers. Based on notable results observed in the metastatic setting, several clinical trials investigated ICIs as neoadjuvant treatment (NAT) for localized dMMR/MSI-H GI cancers, achieving striking results in terms of clinical and pathological responses and creating the opportunity to spare patients from neoadjuvant chemotherapy and/or radiotherapy and even surgical resection. Nevertheless, these impressive findings are mainly derived from small proof of concept phase II studies and there are still several open questions to address. Moreover, dMMR/MSI-H represents a limited subgroup accounting for less than 10% of GI cancers. Consequently, many efforts have been produced to investigate neoadjuvant ICIs also in mismatch repair-proficient/microsatellite stable (MSS) cancers, considering the potential synergistic effect in combining immune-targeted agents with standard therapies such as chemo and/or radiotherapy. However, results for combining ICIs to the standard of care in the unselected population are still unsatisfactory, without improvements in event-free survival in esophago-gastric adenocarcinoma for the addition of pembrolizumab to chemotherapy, and sometimes limited benefit in patients with locally advanced rectal cancer. Therefore, a major challenge will be to identify among the heterogenous spectrum of this disease, those patients that could take advantage of neoadjuvant immunotherapy and deliver the most effective treatment. In this review we discuss the rationale of NAT in GI malignancies, summarize the available evidence regarding the completed trials that evaluated this treatment strategy in both MSI-H and MSS tumors. Finally, we discuss ongoing studies and future perspectives to render neoadjuvant immunotherapy another arrow in the quiver for the treatment of locally advanced GI tumors.
Competing Interests: Competing interests: DC received travel support from Sanofi, BMS and Merck KgA. NF declares Personal Financial Interests for ADACAP, Ipsen (Invited speaker), for ADACAP, Merck, MSD, Novartis, Pfizer, Boehringer (Advisory Board); Institutional Financial Interests: local PI of trials for 4SC, Astellas, Beigene, Fibrogen, Incyte, Ipsen, Nucana; research grants from ADACAP, Ipsen, MSD, Merck. Other Authors declare no conflict of interests.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: Gastrointestinal Neoplasms; Immune Checkpoint Inhibitors; Immunotherapy; Programmed Cell Death 1 Receptor; Radiotherapy
المشرفين على المادة: 0 (Immune Checkpoint Inhibitors)
تواريخ الأحداث: Date Created: 20240523 Date Completed: 20240523 Latest Revision: 20240606
رمز التحديث: 20240607
مُعرف محوري في PubMed: PMC11116869
DOI: 10.1136/jitc-2023-008027
PMID: 38782539
قاعدة البيانات: MEDLINE
الوصف
تدمد:2051-1426
DOI:10.1136/jitc-2023-008027