JLE

Hépato-Gastro & Oncologie Digestive

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Treatment of digestive cancers with immunotherapy Volume 28, issue 8, Octobre 2021

Author
Hôpital Saint-Louis, Service de gastroentérologie et cancérologie digestive, 1 avenue Claude Vellefaux, 75010 Paris
* Correspondance

Recently, immune checkpoint inhibitor (ICI) treatments have been shown to be effective in the treatment of esogastric, dMMR/MSI colorectal cancers and hepatocellular carcinomas (HCC). Several European marketing authorizations have recently been obtained for the treatment of esophageal, colorectal dMMR/MSI and HCC cancers, other applications have been submitted concerning gastric adenocarcinomas. Sustained responses are observed in varying proportions depending on the location and the tumor biology. The tolerance of ICI monotherapy is overall better than that of chemotherapy. The level of PD-L1 expression in the tumor is a predictor of efficacy in some tumors. ICIs have not been shown to be effective in the treatment of certain tumors, including pMMR/MSS colorectal cancers and adenocarcinomas of the pancreas. New questions of therapeutic strategy appear with the introduction of this therapeutic class, in particular treatments after escape from immunotherapy or the identification of patients who have primary resistance to ICI. Finally, new combinations of immunotherapy are being studied in the treatment of cancers refractory to ICI.