Prognostic significance of tumor immune microenvironment and immunotherapy:Novel insights and future perspectives in gastric cancer

作     者：Daniela Cornelia Lazǎr Mihaela Flavia Avram Ioan Romosan Mǎrioara Cornianu Sorina Tǎan Adrian Goldis 

作者机构：Department of Internal Medicine IUniversity Medical ClinicUniversity of Medicine and Pharmacy"Victor Babes"Timisoara 300041Timis CountyRomania Department of Surgery X1st Surgery ClinicUniversity of Medicine and Pharmacy"Victor Babes"Timisoara 300041Timis CountyRomania Department of PathologyUniversity of Medicine and Pharmacy"Victor Babes"Timisoara 300041Timis CountyRomania Department of Gastroenterology and HepatologyUniversity of Medicine and Pharmacy"Victor Babes"Timisoara 300041Timis CountyRomania 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2018年第24卷第32期

页      面：3583-3616页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：immunotherapy prognostic significance tumor immune microenvironment immune checkpoint inhibitors gastric cancer 

摘      要：Despite a decrease in gastric cancer incidence, the development of novel biologic agents and combined therapeutic strategies, the prognosis of gastric cancer remains poor. Recently, the introduction of modern immunotherapy, especially using immune checkpoint inhibitors, led to an improved prognosis in many cancers. The use of immunotherapy was also associated with manageable adverse event profiles and promising results in the treatment of patients with gastric cancer, especially in heavily pretreated patients. These data have led to an accelerated approval of some checkpoint inhibitors in this setting. Understanding the complex relationship between the host immune microenvironment and tumor and the immune escape phenomenon leading to cancer occurrence and progression will subsequently lead to the identification of prognostic immune markers. Furthermore, this understanding will result in the discovery of both new mechanisms for blocking tumor immunosuppressive signals and pathways to stimulate the local immune response by targeting and modulating different subsets of immune cells. Due to the molecular heterogeneity of gastric cancers associated with differentclinico-biologic parameters, immune markers expression and prognosis, novel immunotherapy algorithms should be personalized and addressed to selected subsets of gastric tumors, which have been proven to elicit the best clinical responses. Future perspectives in the treatment of gastric cancer include tailored dual immunotherapies or a combination of immunotherapy with other targeted agents with synergistic antitumor effects.