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Gastric adenocarcinoma and esophageal adenocarcinoma are aggressive cancers with a poor prognosis. Therefore, new therapeutic strategies are needed, especially for patients refractory to conventional treatment. Cancer immunotherapy (CIT), is a promising new treatment option and is effective in a proportion of patients with gastroesophageal malignancies. Biomarkers for selecting patients likely to benefit from CIT in gastroesophageal malignancies remain unproven. Programmed cell death ligand-1 (PD-L1), which is a validated biomarker in non-small cell lung cancer (NSCLC), is often also used to select patients for CIT in the context of gastroesophageal cancer, although this marker has not been validated for this purpose. We question the use of PD-L1 as a biomarker in gastroesophageal cancers, as there are fundamental differences in PD-L1 expression between NSCLC and gastroesophageal cancers. This review discusses the value of PD-L1 in selecting patients for CIT in esophageal and gastric cancer. Potential alternatives, especially microsatellite instability and Epstein-Barr virus positivity, are discussed.
This article was published in the following journal.
Name: Cancer letters
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Success in bringing an effort to the desired end; the degree or level of success attained in some specified area (esp. scholastic) or in general.
One of the principal schools of medical philosophy in ancient Greece and Rome. It developed in Alexandria between 270 and 220 B.C., the only one to have any success in reviving the essentials of the Hippocratic concept. The Empiricists declared that the search for ultimate causes of phenomena was vain, but they were active in endeavoring to discover immediate causes. The "tripod of the Empirics" was their own chance observations (experience), learning obtained from contemporaries and predecessors (experience of others), and, in the case of new diseases, the formation of conclusions from other diseases which they resembled (analogy). Empiricism enjoyed sporadic continuing popularity in later centuries up to the nineteenth. (From Castiglioni, A History of Medicine, 2d ed, p186; Dr. James H. Cassedy, NLM History of Medicine Division)
Guideline for determining when it is morally permissible to perform an action to pursue a good end with knowledge that the action will also bring about bad results. It generally states that, in cases where a contemplated action has such double effect, the action is permissible only if: it is not wrong in itself; the bad result is not intended; the good result is not a direct causal result of the bad result; and the good result is "proportionate to" the bad result. (from Solomon, "Double Effect," in Becker, The Encyclopedia of Ethics, 1992)
Form of passive immunization where previously sensitized immunologic agents (cells or serum) are transferred to non-immune recipients. When transfer of cells is used as a therapy for the treatment of neoplasms, it is called adoptive immunotherapy (IMMUNOTHERAPY, ADOPTIVE).
Form of adoptive transfer where cells with antitumor activity are transferred to the tumor-bearing host in order to mediate tumor regression. The lymphoid cells commonly used are lymphokine-activated killer (LAK) cells and tumor-infiltrating lymphocytes (TIL). This is usually considered a form of passive immunotherapy. (From DeVita, et al., Cancer, 1993, pp.305-7, 314)
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