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Targeting the PD-1 pathway: a new hope for gastrointestinal cancers
- Source :
- Current Medical Research and Opinion. 33:749-759
- Publication Year :
- 2017
- Publisher :
- Informa UK Limited, 2017.
-
Abstract
- VEGF, HER2 and EGFR targeted agents are currently used in gastric, esophageal and colorectal cancers. However, treatment outcomes are still poor in most gastrointestinal (GI) cancers. Immune checkpoints are one of the most promising immunotherapy approaches. In this review article, we aim to discuss the efficacy and safety of anti-PD-1/PD-L1 therapies in GI cancers, including gastric, esophageal and colorectal cancer in published or reported recent studies.A literature search was made from PubMed and ASCO Annual Meeting abstracts by using the following search keywords: "nivolumab", "pembrolizumab", "avelumab", "GI cancers" "anti-PD1 therapy" and "anti-PD-L1 therapy". The last search was on 2 November 2016. The most important limitation of our review is that most of the data on anti-PD-1/PD-L1 therapies in GI cancers relies on phase 1 and 2 trials.Currently, there are two anti-PD-1 (nivolumab and pembrolizumab) and one anti-PDL1 (atezolizumab) agents approved by FDA. After the treatment efficacy of immune checkpoint blockade was shown in melanoma, renal cell cancer and non-squamous lung cancer, trials which evaluate immune checkpoint blockade in GI cancers are ongoing. Early results of trials have been promising and encouraging for patients with advanced stage gastroesophageal cancer. According to early results of published trials, response to anti-PD1/PD-L1 agents appears to be associated with tumor PD-L1 levels. According to two recently published phase 2 trials, the clinical benefits of immune checkpoint blockade with both nivolumab and pembrolizumab were limited in patients with microsatellite instability (MSI) positive advanced colorectal cancer. However, several phase 2/3 trials are still ongoing.Both pembrolizumab and nivolumab show promising efficacy with acceptable safety data in published trials in GI cancers, especially in refractory MSI positive metastatic colorectal cancer.
- Subjects :
- 0301 basic medicine
Oncology
medicine.medical_specialty
Colorectal cancer
medicine.medical_treatment
Antineoplastic Agents
Apoptosis
Pembrolizumab
Avelumab
03 medical and health sciences
0302 clinical medicine
Atezolizumab
Internal medicine
medicine
Humans
Molecular Targeted Therapy
Gastrointestinal cancer
Gastrointestinal Neoplasms
business.industry
Antibodies, Monoclonal
General Medicine
Immunotherapy
medicine.disease
Review article
Treatment Outcome
030104 developmental biology
030220 oncology & carcinogenesis
Nivolumab
business
medicine.drug
Subjects
Details
- ISSN :
- 14734877 and 03007995
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Current Medical Research and Opinion
- Accession number :
- edsair.doi.dedup.....c74e46af18dd4a60bb61c6024e3c6cc1