免疫检查点抑制剂联合抗血管生成药物治疗pMMR/MSS型结直肠癌的机制与临床研究进展OA
Research progress in mechanisms and clinical applications of immune checkpoint inhibitors combined with anti-angiogenic drugs in the treatment of pMMR/MSS colorectal cancer
结直肠癌(CRC)是全球高发恶性肿瘤,免疫检查点抑制剂(ICI)的出现为其治疗提供了更多选择.然而,约85%的错配修复功能完整或微卫星稳定(pMMR/MSS)型CRC因肿瘤突变负荷低、免疫原性弱及高度免疫抑制微环境,对ICI单药响应率极低,成为CRC免疫治疗的主要困境.ICI联合抗血管生成药物(AAD)为CRC的治疗提供了新思路.该文系统综述了ICI联合AAD治疗pMMR/MSS型CRC的作用机制,并重点讨论了AtezoTRIBE、CAPability-01等关键临床研究进展,有助于深入了解pMMR/MSS型CRC的"冷肿瘤"特性以及ICI联合AAD的协同增效机制,以期为该亚型的免疫联合治疗方案提供理论借鉴.
Colorectal cancer(CRC)is a highly prevalent malignant tumor worldwide.The emergence of immune checkpoint inhibitors(ICIs)has provided more therapeutic options.However,approximately 85%of proficient mismatch repair or microsatellite stable(pMMR/MSS)CRC cases have extremely low response rates to ICIs monotherapy.This resistance is attributed to the low tumor mutational burden,weak immunogenicity,and highly immunosuppressive tumor microenvironments,posing a major challenge to CRC immunotherapy.The combination of ICIs with anti-angiogenic drugs(AADs)(ICI-AAD therapy)has led to a novel therapeutic paradigm for CRC.This review summarizes the mechanisms behind and recent advances in the ICI-AAD therapy for pMMR/MSS CRC in general and key clinical studies such as AtezoTRIBE and CAPability-01 in particular.By elucidating the immunologically"cold tumor"pathophysiology of p MMR/MSS CRC and the synergistic interplay of ICI-AAD therapy,this study is expected to provide data for optimizing combinatorial immunotherapy for this subtype.
袁汇;李红;宋扬
西安医学院,西安 710021||空军军医大学唐都医院肿瘤科,西安 710038空军军医大学唐都医院肿瘤科,西安 710038空军军医大学唐都医院肿瘤科,西安 710038
医药卫生
结直肠癌错配修复功能完整微卫星稳定免疫检查点抑制剂抗血管生成药物免疫抑制微环境
colorectal cancermismatch repair proficientmicrosatellite stabilityimmune checkpoint inhibitorsanti-angiogenic drugsimmunosuppressive microenvironment
《军事医学》 2026 (4)
297-304,8
陕西省科技厅基金项目(2025JC-YBMS-1011)
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