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作 者:黄月雨 余昶 王佳慧 王长春 叶雪梅 毛伟敏 赵安 HUANG Yue-yu;YU Chang;WANG Jia-hui;WANG Chang-chun;YE Xue-mei;MAO Wei-min;ZHAO An(Zhejiang Chinese Medical University,the 2nd Clinical Medical College,Hangzhou 310053,China;The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Institute of Basic Medicine and Cancer(IBMC),Chinese Academy of Sciences,Hangzhou 310022,China;Zhejiang Provincial Key Laboratory of Thoracic Cancer Diagnosis and Treatment Technology,Hangzhou 310022,China;Jiangxi Cancer Hospital,Thoracic Cancer Laboratory,Nanchang 330029,China)
机构地区:[1]浙江中医药大学第二临床医学院,浙江杭州310053 [2]中国科学院大学附属肿瘤医院(浙江省肿瘤医院)中国科学院基础医学与肿瘤研究所,浙江杭州310022 [3]浙江省胸部肿瘤诊治技术研究重点实验室,浙江杭州310022 [4]江西省肿瘤医院胸部肿瘤研究室,江西南昌330029
出 处:《中国肿瘤》2022年第7期562-568,共7页China Cancer
基 金:国家自然科学基金面上项目(82172567)。
摘 要:胸腺上皮肿瘤是一种起源于胸腺上皮细胞的纵隔常见恶性肿瘤。手术治疗是目前的主要治疗方式,对于复发及难治性胸腺上皮肿瘤多推荐进行放化疗等辅助治疗,但以铂类为主的化疗、分子靶向治疗及放疗的治疗疗效依然有限。免疫治疗已成为肿瘤的辅助或新辅助治疗的重要选择之一,其中针对细胞毒性T淋巴细胞抗原-4、PD-1和PD-L1等免疫检查点的抑制剂已被批准用于许多实体肿瘤的治疗。与传统疗法相比,这些免疫检查点抑制剂具有更好的疗效和更低的毒性。但可能由于胸腺独特的生物学特性,免疫治疗通常会引起严重的免疫相关不良事件,增加了这些患者免疫治疗获益的不确定性。该文总结了胸腺上皮肿瘤的免疫生物学,讨论了有关免疫检查点抑制剂的现有数据和这一治疗策略的未来前景。Thymic epithelial tumor is a common mediastinal malignant tumor originating from thymic epithelial cells. Local surgical resection is the main therapeutic modality at present, and the efficacy of targeted and other adjuvant therapies for recurrent and refractory thymic epithelial tumors is limited. Immunotherapy has become one of the important options for adjuvant or neoadjuvant therapy of tumors, and antibodies targeting immune checkpoints such as anti CTLA-4, PD-1and PD-L1 have been approved for the treatment of many solid tumors. These immune checkpoint inhibitors are more effective and less toxic than conventional therapies. However, due to the unique biological features of the thymus, immunotherapy often causes severe immune-related adverse events, increasing uncertainty about the feasibility of immunotherapy in these patients. In this article, the immunobiology of thymic tumors is reviewed and the available data on immune checkpoint inhibitors and the future prospects of this therapeutic strategy are discussed.
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