强强联合,持久获益——系统性治疗失败的MSI⁃H/dMMR转移性结直肠癌的免疫联合治疗

Strong Combination,Long⁃Lasting Benefit:Immunothera⁃py Combination for MSI⁃H/dMMR Metastatic Colorectal Cancer That Has Failed Systemic Treatment

1文献来源Overman MJ,Lonardi S,Wong KYM,et al.Durable clinical benefit with nivolumab plus ipilimumab in DNA mismatch repair⁃deficient/microsatellite instability⁃high metastatic colorectal cancer[J].J Clin Oncol,2018,36(8):773-779.2证据水平1b。3背景结直肠癌是全球癌症相关死亡的主要原因,转移性结直肠癌(metastatic colorectal cancer,mCRC)患者的5年生存率仅14%。其中,微卫星高度不稳定(microsatellite instability⁃high,MSI⁃H)/错配修复基因缺陷(mismatch repair⁃deficient,dMMR)型结直肠癌是一类独特的肠癌类型,在晚期肠癌中约占5%。与微卫星稳定(microsatellite stability,MSS)/错配修复基因正常(mismatch repair⁃proficient,pMMR)的肠癌相比,该类型的肠癌对常规化疗不敏感,预后较差。