Chemo treatment
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Advances in Chemotherapy Treatment: A Comprehensive Overview
Chemo-Immunotherapy: Combining Forces for Enhanced Cancer Treatment
Chemo-immunotherapy is an innovative approach that merges traditional chemotherapy with immunotherapy to improve cancer treatment outcomes. This combination aims to target cancer cells directly through chemotherapy while simultaneously enhancing the immune system's ability to fight cancer via immunotherapy. Recent studies have demonstrated promising results in treating various cancers, including melanoma and lung cancer, with chemo-immunotherapy . However, the optimal dosing, timing, and sequencing of these treatments are still under investigation.
Chemotherapy and Chemoradiotherapy in Gastric Cancer
In the treatment of resectable gastric cancer, both perioperative chemotherapy and postoperative chemoradiotherapy have been shown to improve survival rates. A significant study compared these two strategies head-to-head, revealing that postoperative chemoradiotherapy did not significantly improve overall survival compared to postoperative chemotherapy alone. This finding suggests that future research should focus on optimizing preoperative treatment strategies to enhance patient outcomes.
Adjuvant Chemotherapy for Rectal Cancer
The role of adjuvant chemotherapy in rectal cancer patients who have undergone preoperative (chemo)radiotherapy and total mesorectal excision (TME) remains a topic of debate. A randomized phase III trial found no significant benefit of adjuvant chemotherapy over observation in terms of overall survival, disease-free survival, and recurrence rates. This suggests that adjuvant chemotherapy may not be necessary for all rectal cancer patients following preoperative treatment and surgery.
Pembrolizumab vs. Chemotherapy for Advanced Esophageal Cancer
Pembrolizumab, an immunotherapy drug, has shown significant improvements in overall survival compared to chemotherapy as a second-line treatment for advanced esophageal cancer, particularly in patients with a PD-L1 combined positive score (CPS) of 10 or higher. This supports pembrolizumab as a new standard of care for these patients, offering a more favorable safety profile and better outcomes.
Sintilimab Plus Chemotherapy for Gastric Cancer
The ORIENT-16 trial demonstrated that sintilimab, a PD-1 inhibitor, combined with chemotherapy significantly improved overall survival in patients with advanced gastric or gastroesophageal junction adenocarcinoma, especially in those with a PD-L1 CPS of 5 or higher. This combination therapy is now considered a standard of care for first-line treatment in these patients.
Immunogenic Cell Death and Nanomedicine in Chemo-Immunotherapy
Certain chemotherapeutic drugs, such as doxorubicin and oxaliplatin, can induce immunogenic cell death (ICD) in tumor cells, triggering specific antitumor immune responses. This has led to the development of nanomedicine-based chemo-immunotherapy, which aims to enhance treatment effectiveness by reversing the immunosuppressive tumor microenvironment . Functional nanomaterials play a crucial role in co-delivering chemo-immunotherapeutic agents and modulating the tumor microenvironment to improve therapeutic outcomes .
Total Neoadjuvant Therapy for Rectal Cancer
Total neoadjuvant therapy, which includes chemoradiotherapy plus induction or consolidation chemotherapy, has been increasingly adopted for treating locally advanced rectal cancer. A study found that chemoradiotherapy followed by chemotherapy resulted in higher pathological complete response rates without compromising disease-free survival, toxicity, or quality of life. This sequence is proposed as the preferred approach when organ preservation is a priority.
Neoadjuvant vs. Adjuvant Chemoendocrine Therapy for Breast Cancer
A randomized clinical trial compared neoadjuvant (pre-surgery) and adjuvant (post-surgery) chemoendocrine therapy in women with primary operable breast cancer. The study found a high response rate to neoadjuvant therapy, with a significant reduction in the need for mastectomy compared to adjuvant therapy. However, long-term survival data are still needed to fully evaluate the benefits of neoadjuvant treatment.
Chemo-IO vs. IO Alone for Advanced NSCLC
A pooled analysis of multiple trials investigated the efficacy of combining chemotherapy with immunotherapy (chemo-IO) versus immunotherapy alone (IO) in patients with advanced non-small cell lung cancer (NSCLC) with a PD-L1 score of 50% or higher. The results suggested that chemo-IO regimens may offer better overall survival and progression-free survival compared to IO alone, supporting the use of chemo-IO in this patient population.
Conclusion
The landscape of chemotherapy treatment is continually evolving, with significant advancements in combining chemotherapy with immunotherapy, optimizing treatment strategies for various cancers, and exploring the role of nanomedicine. These developments hold promise for improving patient outcomes and offer new hope in the fight against cancer.
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