[评论] 重新定义早期错配修复缺陷型结肠癌的治愈性治疗
摘要
数十年来，对可切除的II期和III期结肠癌患者的标准治疗一直以手术为中心，并考虑术后辅助全身治疗以降低复发风险。错配修复缺陷见于10–15%的非转移性结肠癌，并且是免疫检查点抑制治疗反应的预测指标。单臂、II期NICHE-2研究的初步报告，针对临床II期和III期结肠癌患者在手术前给予一剂伊匹木单抗（1 mg/kg）和两剂纳武利尤单抗（3 mg/kg），在显示出显著的98%病理学缓解率（包括68%的病理学完全缓解率）后引起了广泛关注。
English
For decades, the standard of care for patients with resected stage II and III colon cancer has centred on surgery with consideration of postoperative adjuvant systemic therapy to reduce risk of recurrence. Mismatch repair deficiency is seen in 10–15% of non-metastatic colon cancers and is predictive of response to immune checkpoint inhibition. The initial report of the single-arm, phase 2 NICHE-2 study of one dose of ipilimumab (1 mg per kg) and two doses of nivolumab (3 mg per kg) before surgery with clinical stage II and III colon cancer generated considerable interest after demonstrating a remarkable 98% pathologic response rate, including a pathologic complete response rate of 68%.