晚期食道癌免疫治療之新進展

Recent Advances in the Immunotherapy of Advanced Esophageal Cancer

食道癌是一個全球性的健康問題，進展迅速且致命，3分之2的患者確診時已罹患晚期或轉移性疾病，5年存活率不到2成，整體預後不佳。自2017年國際間有數個食道癌免疫治療的臨床試驗發表，包含單獨使用或是併用化學治療，結果顯著改善整體預後，為晚期或轉移性食道癌的治療帶來曙光。免疫療法藉由免疫調控的機制，使免疫系統增加癌細胞的毒殺能力以達到治療效果，旨在防止免疫逃逸和調節免疫微環境。本文主要以文獻回顧方式，綜論近幾年轉移或復發食道癌免疫治療的新發展和臨床試驗。

Esophageal cancer is a global health burden. It is a rapid progressive and fatal disease, with two-thirds of patients diagnosed with advanced or metastatic disease, and a five-year survival rate of less than 20%. Since 2017, several clinical trials of immunotherapy for advanced esophageal cancer have been published, applying immunotherapy alone or in combination with chemotherapy. These researches demonstrated significantly improved prognoses and brought hope for the treatment of advanced or metastatic esophageal cancer. The mechanisms of immunotherapy rely on modulation of immune checkpoints to kill cancer cells, prevention of immune escape and regulation of immune microenvironment. This article reviews new developments and clinical trials of immunotherapy for advanced or recurrent/metastatic esophageal cancer in recent years.