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Cancer treatment and research
2024;192 277-303.

Immunotherapy in Gastrointestinal Cancers.

Hazel Lote, Ian Chau
Author Information
  1. Hazel Lote: The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, UK.
  2. Ian Chau: The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, UK. ian.chau@rmh.nhs.uk.
PMID: 39212926 DOI: 10.1007/978-3-031-61238-1_14

Abstract

Immunotherapy has revolutionised cancer treatment over the past decade. Long-term durable responses can be achieved in some cancer patient populations that were previously facing terminal disease. In this chapter, we summarise current phase 3 clinical trial evidence for the use of immunotherapy in gastrointestinal cancers (oesophageal squamous cell carcinoma, oesophago-gastric adenocarcinoma, pancreatic cancer, biliary cancer, hepatocellular carcinoma, colorectal cancer, and squamous cell cancer of the anus). We discuss meaningful biomarkers used in clinical trials to select patients most likely to benefit from immunotherapy, such as mismatch-repair deficiency (MMRd)/microsatellite instability (MSI) and programmed-death-ligand-1 (PD-L1) immunohistochemistry (IHC) expression. Clinical questions are arising regarding the role of immunotherapy in the adjuvant/perioperative setting, optimal timing of surgery in patients who respond to immunotherapy, and toxicities specific to patients with gastrointestinal malignancies. We outline the current landscape and future horizon of immunotherapy in gastrointestinal cancers, such as strategies to increase effectiveness of checkpoint blockade through combinations with other checkpoint inhibitors, cytotoxic chemotherapy, targeted agents, radiotherapy, CAR-T therapy, and cancer vaccines.

Keywords

Anal cancer Biliary cancer Checkpoint inhibition Colorectal cancer Gastrointestinal malignancies Hepatocellular carcinoma Immunotherapy Oesophago-gastric cancer PD-1 and PD-L1 inhibition Pancreatic cancer

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MeSH Term

Humans
Gastrointestinal Neoplasms
Immunotherapy
Journal Article Review

Word Cloud

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