临床肿瘤免疫治疗技术的突破和问题  

Breakthrough and Obstacles of Clinical Cancer Immunotherapy

作　　者：王歈[1] 

机构地区：[1]中国人民解放军总医院转化医学中心实验室,北京100853

出　　处：《医学与哲学（B）》2015年第2期10-12,34,共4页Medicine & Philosophy(B)

摘　　要：通过干预、改造肿瘤患者T细胞进行肿瘤免疫治疗的方法,在部分类型的肿瘤患者取得了长期缓解的疗效。其中包括非特异性解除患者T细胞免疫抑制(阻断免疫检查点)可以使约20%的黑色素瘤和非小细胞肺癌患者获得长期缓解;通过基因转染赋予患者T细胞识别肿瘤细胞抗原和活化的信号,嵌合抗原受体-T细胞(CAR-T)治疗在致死性儿童急性淋巴细胞白血病中取得了约90%的疗效。长期疗效达到75%。这些临床成果,使得肿瘤免疫治疗逐步成为部分肿瘤治疗的一线治疗方案。然而,受到肿瘤高度异质性、能够选择肿瘤抗原的有限性、肿瘤免疫逃逸多重机制的影响,肿瘤免疫治疗仍有许多关键问题需要基础和临床研究进行尝试和解决。Cancer immunotherapy has achieved long term responses in some cancer types and pauents. It has been approvea that non-specific inhibition of immune checkpoints can benefit about 20% of patients, including melanoma and non-small cell lung cancer. By introducing cancer antigen specific recognition and activation signals, CAR-T therapy showed 90 % of CR responses in lethal acute lymphoid leukemia of children, and 75 % long term responses. These results are making cancer immunotherapy as the first line therapy in some cancer types. However, there are still many key technology issues to be sorted out to expand the application of immunotherapy in other cancer types due to cancer heterogeneity, limitation of cancer antigens to be targeted, and multiple immune escaping mechanisms adopted by cancer cells.

关 键 词：肿瘤免疫治疗 免疫检查点 嵌合抗原受体-T细胞 T细胞受体 

分 类 号：R730.51[医药卫生—肿瘤]