摘要
非小细胞肺癌(NSCLC)严重威胁患者的生存质量,传统治疗手段存在副作用大、易复发、易耐药、缺乏特异性等缺点。基于免疫检查点阻断的免疫疗法是近年来肿瘤治疗领域的突破性进展,它将肿瘤治疗从“点”向“面”转换,是一种以T细胞功能调控为重点,进而控制肿瘤进展的新策略。程序性死亡蛋白1(PD-1)是研究最充分的免疫检查点分子。近年来,靶向PD-1及其配体PD-L1信号通路的免疫疗法凭借其特异性较强、副作用小等优势,已经在NSCLC治疗中获得了令人振奋的疗效,但是仍有相当一部分患者对靶向PD-1/PD-L1通路的单一抗体治疗效果不显著,研究表明,基于PD-1/PD-L1通路的靶向免疫疗法联合其他肿瘤治疗手段能够显著提高患者的生存率和生存质量。例如放化疗、双免疫检查点、免疫调节物质,甚至肠道菌群调节均可联合抗PD-1/PD-L1单抗应用于NSCLC的临床治疗,这些联合疗法各有其优缺点,其协同作用机制也有待更进一步研究。对于NSCLC而言,更多基于PD-1/PD-L1阻断的新型联合疗法也在探索中,从而为提高患者生存率和生存质量奠定基础。
Non-small cell lung cancer(NSCLC)is one of the most serious malignancies and a serious threat to patients*quality of life.Traditional treatment have limitations such as side-effects,recurrence,drug resistance and lack of specificity.A novel therapy with immune checkpoint blocking has marked a breakthrough in the field of tumor therapy.It transforms the target of tumor therapy from a single molecule to immune cells,and provides a new strategy with a focus on the regulation of T cell function to control tumor progression.Programmed death 1(PD-1)is the most well-studied immune checkpoint molecules.In recent years,profound progress was made in developing immunotherapies targeting the PD-1/PD-L1 signaling pathway,particularly in the treatment of NSCLC,given their high specificity and low side-effects.Nevertheless,there are still a considerable number of patients who have no significant therapeutic effect after receiving single antibodies that block the PD-1/PD-L1 pathway.Studies have shown that immunotherapy targeting the PD-1/PD-L1 pathway in the combination with other therapies can significantly improve survival rate and quality of life in patients.Such as radiotherapy and chemotherapy,dual immune checkpoint intervention,immunomodulator intervention,and even intestinal flora regulation can also be combined with anti-PD-1/PD-L1 antibody for clinical treatment of NSCLC.These combination therapies have their own strengths and limitations,and their synergy mechanism requires further study.For NSCLC,more potential combined therapies based on PD-1/PD-L1 blockade are also being explored,laying a foundation for improving the survival rate and quality of life of NSCLC patients.
作者
张宁宁
王旭
沈金澳
孙世昱
沈燕
王军
ZHANG Ningning;WANG Xu;SHEN Jinao;SUN Shiyu;SHEN Yan;WANG Jun(Second Student Brigade,School of Basic Medicine,Air Force Medical University,Xi'an 710032,China;Department of Medical Microbiology and Parasitology,School of Basic Medicine,Air Force Medical University,Xi'an 710032,China)
出处
《细胞与分子免疫学杂志》
CAS
CSCD
北大核心
2022年第5期472-478,共7页
Chinese Journal of Cellular and Molecular Immunology
基金
国家自然科学基金(82002158,81702019)。
