食管鳞癌免疫治疗的临床进展

Clinical progress of immunotherapy for esophageal squamous cell carcinoma

目的总结食管鳞癌免疫治疗策略等研究现状。方法检索PubMed、中国知网和临床试验注册台(Clinical Tri als.gov),以“食管鳞状细胞癌、免疫治疗、免疫检查点抑制剂、程序性死亡分子(PD-1)/程序性死亡配体-1(PD-L1)和新辅助等”为关键词,检索2012-01-2020-11相关文献。纳入标准:(1)免疫治疗在食管鳞癌中的进展;(2)免疫检查点抑制剂在肿瘤免疫治疗中的应用;(3)PD-1/PD-L1在食管鳞癌治疗中的研究进展;(4)免疫治疗在围手术期的应用。排除标准:(1)晚期不可切除食管鳞癌的姑息治疗;(2)食管及胃食管结合部腺癌的免疫治疗。根据上述标准分析32篇文献。结果免疫治疗作为一种新的治疗方法,在多个肿瘤领域取得巨大成效,一系列临床研究取得突破性进展。Pembroli zumab现已成为指南推荐的晚期食管癌二线治疗的标准方案。另外,围手术期应用免疫治疗,免疫治疗与化疗相结合也表现出了较高的疾病控制率,延长了肿瘤无进展时间及患者总生存期。结论免疫治疗在食管麟癌治疗领域拥有无限潜力,以免疫治疗为主,其他抗肿瘤治疗方式联合治疗或将成为食管癌治疗的新方向。

Objective To review the research status of immunotherapy strategies for esophageal squamous cell carcinoma(ESCC) retrospectively.Methods Search PubMed,CNKI,Clinical Trial Registration Station(Clinical Trials.gov),with "esophageal squamous cell carcinoma;immunotherapy;immune checkpoint inhibitor;programmed death molecule(PD-1)/programmed death ligand-1(PD-L1);new assistant" as keywords from 2012 to 2020.Inclusion criteria:(1)progress of immunotherapy in esophageal squamous cell carcinoma;(2)the application of immune checkpoint inhibitors in tumor immunotherapy;(3)research progress of PD-1/PD-L1 in the treatment of esophageal squamous cell carcinoma;(4)the application of immunotherapy in perioperative period.Thirty-one articles were analyzed according to inclusion criteria.Results As a new treatment method,immunotherapy has made great achievements in many tumor fields,and a series of clinical studies have made breakthrough progress.Now,immunotherapy has become the standard regimen for second-line treatment of advanced esophageal cancer recommended by guidelines.In addition.Perioperative use of immunotherapy and the combination of immunotherapy and chemotherapy also showed a higher rate of disease control,prolonged tumor progression time and overall survival.Conclusions Immunotherapy has unlimited potential in the field of esophageal cancer treatment.The combination of immunotherapy and other anti-tumor therapies may become a new direction in the treatment of esophageal cancer.