摘要
神经内分泌肿瘤(NEN)是少见的异质性肿瘤,不同病理类型、分化程度、分级和分期的NEN治疗和转归差异较大。晚期NEN可供选择的药物较少,目前尚缺乏有效治疗手段。免疫治疗是近几年肿瘤治疗领域最重要的突破,免疫检查点抑制剂在多个实体瘤中显示出较好疗效。免疫治疗在NEN中的探索研究结果显示,免疫单药治疗NEN的疗效有限,对于部分选择性人群可以考虑应用。与免疫治疗效果相关的生物标记物包括PD-L1表达、肿瘤突变负荷高(TMB-H)和微卫星高度不稳定/错配修复缺陷(MSI-H/dMMR)等。抗CTLA-4联合PD-1/PD-L1抑制剂、免疫联合靶向治疗或细胞毒药物在NEN患者中取得了一定的疗效,值得进一步探讨其获益人群。
Neuroendocrine neoplasms(NEN)is a rare and heterogeneous tumor.Different pathologic morphology,differentiation,grade and clinical stages of the tumors had various treatment and prognosis.Patients with recurrent or metastatic NEN have limited treatment options and poor prognosis.In recent years,PD-1 pathway blockade has become integral components of disease management for many cancers.Immunotherapy is being explored in NEN.Studies have shown that the efficacy of immune monotherapy in NEN is limited,and it can be considered for selected patients.Biomarkers for predicting efficacy of immunotherapy include PD-L1 expression,TMB-H,MSI-H/dMMR,etc.Combined regimens of anti-CTLA-4 and anti-PD-1/PD-L1 inhibitors,and immune checkpoint inhibitor combined with anti-angiogenic drugs or chemotherapy are promising in patients with NEN,and it is worthwhile to further explore of the responding populations.
作者
张盼盼
陆明
沈琳
Zhang Panpan;Lu Ming;Shen Lin(Department of Oncology,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Peking University Cancer Hospital&Institute,Beijing 100142,China)
出处
《中华胃肠外科杂志》
CSCD
北大核心
2021年第10期861-866,共6页
Chinese Journal of Gastrointestinal Surgery
基金
北京市属医学科研院所公益发展改革试点项目(京医研2019-1)。
