中国实用外科杂志

中国实用外科杂志

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免疫治疗时代胃癌围手术期治疗若干焦点问题#br#

丁学伟，梁    寒   

  1. 天津医科大学肿瘤医院胃部肿瘤科  国家恶性肿瘤临床医学研究中心  天津市恶性肿瘤临床医学研究中心  天津市消化系统肿瘤重点实验室，天津  300060
  • 出版日期:2024-10-01

  • Online:2024-10-01

摘要： 以程序性死亡受体及其配体单抗为代表的免疫治疗药物显著改善了晚期胃癌病人的生存结局。新辅助化疗+D2根治术是目前胃癌标准治疗策略之一。近年来，多项胃癌围手术期化疗联合免疫治疗的研究结果显示，围手术期化疗+免疫治疗显著提高了病理完全缓解率。ATTRACTION-5和KEYNOTE585研究结果未能达到预期，MATTERHONE研究的近期疗效较为显著，值得期待。免疫优势人群的筛选和精准治疗是围手术期免疫治疗中需解决的主要问题。

关键词: 局部进展期胃癌, 围手术期, 免疫治疗

Abstract: Immunotherapy represented by PD-1/PD-L1 monoclonal antibody has significantly improved the survival outcome of patients with advanced gastric cancer. Neoadjuvant chemotherapy + D2 radical resection for gastric cancer is one of the current standard treatment strategies for gastric cancer. In recent years, a number of studies on perioperative chemotherapy combined with immunotherapy for gastric cancer have shown that perioperative chemotherapy + immunotherapy significantly improves the pCR rate . The ATTRACTION-5 and KEYNOTE585 studies did not meet expectations, and the short-term efficacy of MATTERHONE is more significant and worth looking forward to. The screening of immunodominant populations and precision treatment are the main problems of perioperative immunotherapy.

Key words: locally advanced gastric cancer, perioperative period, immunotherapy