肝细胞肝癌的免疫治疗现状及研究进展  

Current status and progress of immunotherapy for hepatocellular carcinoma

作　　者：吴虹霖 牛翔科 熊燕[1] 陈志凡[1] 彭涛(指导)[1] WU Hong-Lin;NIU Xiang-Ke;XIONG Yan;CHEN Zhi-Fan;PENG Tao(Radiology Department,Affiliated Hospi-tal of Chengdu University,Chengdu 610081,China)

机构地区：[1]成都大学附属医院放射科,成都610081

出　　处：《中国免疫学杂志》2021年第22期2771-2778,共8页Chinese Journal of Immunology

基　　金：成都市卫生和计划生育委员会科研课题(2018055);四川省卫生和计划生育委员会科研课题(18PJ150,17PJ430)资助。

摘　　要：肝细胞肝癌(HCC)作为最常见恶性肿瘤之一,其发病率呈逐年上升趋势,约占原发性肝癌的75%~85%。约70%~80%HCC患者确诊时已处于中晚期,可接受外科手术切除的患者比例较低,且目前常见的局部治疗手段,如经导管动脉化疗栓塞术(TACE)和射频消融术(RFA)等,对中晚期HCC的治疗效果仍不理想,因此晚期HCC患者五年总生存率(OSR)仅为10%~18%。近年,随着肿瘤免疫机制进一步阐明,其临床试验得到广泛开展。目前中晚期HCC免疫治疗已成为肝癌治疗领域研究热点,其中应用免疫检查点抑制(ICB)和过继性细胞疗法(ACT)治疗HCC的初步临床试验取得良好结果,但单药治疗方案通常患者获益有限,联合多种免疫治疗或将免疫治疗与传统治疗结合的治疗策略能否取得更好效果值得进一步探索。本文拟对HCC免疫治疗进展进行综述,回顾肿瘤疫苗、细胞因子、ACT、ICB、溶瘤病毒和溶瘤细菌等治疗方法,以期为下一步研究奠定基础和提供思路。Hepatocellular carcinoma(HCC)was one of the most common malignancies with increasing incidence,which accounted for approximately 75%~85%primary hepatocarcinomatosis.There were 70%~80%patients with HCC diagnosed in advanced stage frequently with distant metastases or unresectable primary lesion or unacceptable localized therapy initially.For advanced HCC cases,it was not able to get benefits from localized medical treatmental modalities such as either surgical resection,or transarterial chemoembolization(TACE),or radiofrequency ablation(RFA)with poor prognosis of 5-year overall survival only around 10%~18%.Presently,immunotherapy has become a research hotspot for advanced HCC,owing to further elucidation of tumor immune mechanism and clinical trials have been widely carried out.Due to favourable results of preliminary trials of immune checkpoint blockades(ICB)and adoptive cell therapy(ACT)in HCC,neoplastic therapy have been revolutionized.In view of limited benefits of monotherapy,it was worth exploring whether combination of multiple immunotherapies or combination of immunotherapy and traditional therapy could achieve better results.This article reviewed immunotherapy strategies for HCC,such as vaccines,cytokines,AXT,ICB and oncolytic viruses as well as oncolytic bacteria,to lay foundation and provide ideas for further research.

关 键 词：肝细胞肝癌 免疫治疗 免疫检查点抑制 过继性细胞疗法 肿瘤疫苗 

分 类 号：R735.7[医药卫生—肿瘤] R392[医药卫生—临床医学]