作者：饶佳伟，陈创奇

单位：中山大学附属第一医院胃肠外科中心，广东 广州 510080

Authors: Rao Jiawei, Chen Chuangqi

Unit：Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong, China

摘要：

近年来，免疫检查点抑制剂在实体瘤治疗中大放异彩。尤其对于微卫星高度不稳定的结直肠癌患者，免疫检查点抑制剂治疗极大地改善了此类患者的预后。然而，占结直肠癌80%~90%的微卫星稳定型患者对单一免疫检查点抑制剂为主的免疫治疗并不敏感。因此，通过将免疫检查点抑制剂治疗与传统治疗方式联合，来逆转微卫星稳定型结直肠癌组织内部的抑制性免疫微环境；或者通过有效的生物标记对此类患者分层筛选，来明确对免疫检查点抑制剂敏感的人群，是目前研究人员应对此类困境的重要方向。本文将从上述问题对目前晚期结直肠癌免疫治疗如火如荼的研究现状进行阐述。

关键词： 晚期结直肠癌；免疫检查点抑制剂治疗；微卫星稳定型

Abstract：

In recent years, immune checkpoint inhibitor has been widely used in solid tumors. Especially colorectal cancer patients with high microsatellite instability, have derived much benefit. However, 80% to 90% of colorectal cancer patients with microsatellite stabilization are not sensitive to immunotherapy based on single immune checkpoint inhibitor. Therefore, through combining immune checkpoint inhibitor with traditional chemotherapy or targeted therapy, which might reverse the immunosuppressive microenvironment of stable microsatellite colorectal cancer; or screening stable microsatellite patients who are sensitive to immune checkpoint inhibitors through effective biomarkers, were the main directions to deal with this dilemma. This article will discuss the current research status of immunotherapy for advanced colorectal cancer from the above issues.

Key Words:  Advanced colorectal cancer;  Immune checkpoint inhibitor;  Microsatellite stable