PD-1/PD-L1抑制剂联合化疗一线治疗晚期胃癌疗效相关生物标记物的研究进展

免疫检查点抑制剂（immune checkpoint inhibitors，ICIs）联合化疗在晚期胃癌的临床研究中获得了明显的生存获益，但仍有部分胃癌患者对免疫治疗不敏感，存在免疫耐受现象及发生严重的治疗相关不良反应。如何在晚期胃癌患者中，选择ICIs联合化疗的优势人群是临床上亟需解决的问题。本文就晚期胃癌一线治疗的研究进展，对HER2阳性和HER2阴性的晚期胃癌行PD-1/PD-L1抑制剂联合化疗的疗效相关生物标志物，以及其他潜在的生物标记物分别展开综述，探讨其目前的应用现状及面临的问题、挑战及发展趋势。未来开发多个生物标记物联合评估模式及预测模型的建立可能更准确地确定免疫治疗优势人群。 

Research progress of biomarkers related to the efficacy of PD-1/PD-L1 inhibitors combined with chemotherapy as first-line treatment of advanced gastric cancer

The combination of immune checkpoint inhibitors (ICIs) and chemotherapy has achieved significant survival benefits in clinical studies of advanced gastric cancer. This combination has rewritten the treatment strategy for patients with gastric cancer. However, some patients with gastric cancer are insensitive or develop immune tolerance to immunotherapy or develop treatment-related adverse reactions. Thus, it is essential to choose a superior population of ICIs, which, when combined with chemotherapy, may aid in managing patients with advanced gastric cancer. Based on research on the progress of first-line treatment of advanced gastric cancer, we respectively reviewed the efficacy-related biomarkers of PD-1/PD-L1 inhibitors, combined with chemotherapy, for patients with HER-2 positive advanced gastric cancer and HER-2 negative advanced gastric cancer. Other potential biomarkers, and their current application status, problems, challenges, and development trends, were discussed. In the future, developing a combined evaluation model of multiple biomarkers and establishing a prediction model may accurately identify the immunotherapy advantage population.