胃癌免疫治疗获益人群选择

Selection of beneficiaries of immunotherapy for gastric cancer

目前,测定胃癌预测性生物标记物是筛选胃癌免疫治疗获益人群最有效的方法。程序性死亡配体-1(PDL1)表达评分是目前广泛使用的一个评估胃癌免疫治疗疗效的临床生物标记物,但仍需要进一步规范其测定平台、评价指标及指标截止值。虽然微卫星不稳定状态、肿瘤突变负荷水平和EB病毒感染在某些胃癌免疫治疗临床试验中具有良好的预测价值,但仍需要大规模的临床研究进一步验证。POLE/POLD1突变、幽门螺杆菌感染以及液体活检为胃癌免疫治疗预测性生物标记物的研究开辟了新的方向。目前,对于筛选胃癌免疫治疗获益人群仍无准确标准,使用包括PD-L1表达评分在内的多项预测指标共同判定,可能有助于提高筛选的准确性。

Currently,the identification of predictive biomarkers for gastric cancer is paramount in effectively screening individuals who would benefit from immunotherapy for this condition.The Programmed Death Receptor Ligand-1(PD-L1)expression score is a widely utilized clinical biomarker for assessing the effectiveness of immunotherapy in gastric cancer.However,there is still a need for further standardization of the measurement platform,assessment indicators,and cutoff values for PD-L1 expression levels.While microsatellite instability(MSI)status,tumor mutational burden(TMB)levels,and EB virus(EBV)infection have demonstrated promising predictive value in certain clinical trials of gastric cancer immunotherapy,extensive clinical studies are necessary for validation.Moreover,POLE/POLD1 mutations,Helicobacter pylori(Hp)infection,and liquid biopsy have introduced new avenues for investigating predictive biomarkers for gastric cancer immunotherapy.Currently,no precise standard exists for the screening of populations that would benefit from immunotherapy for gastric cancer.The joint utilization of multiple predictive indicators,including the PD-L1 expression score,may enhance the accuracy of screening.