摘要
新抗原作为肿瘤特异性突变产生的免疫靶标,具有正常组织不表达、免疫原性强的核心优势,引领了实体瘤精准免疫治疗新范式。基于新抗原的治疗策略主要包括过继细胞治疗和疫苗两大方向。在细胞治疗领域,新抗原反应性T细胞、T细胞受体工程化细胞(TCR-T)治疗在胃癌、胆管癌、乳腺癌中展现持久抗肿瘤活性;在新抗原疫苗领域,个体化多肽疫苗和mRNA疫苗凭借快速研发及安全性优势崭露头角,显著降低恶性黑色素瘤、胃癌等术后复发风险,联合免疫检查点抑制剂能够延长晚期实体瘤生存期。当前新抗原免疫治疗的挑战集中于新抗原预测准确性、肿瘤异质性、体内递送效率及实体瘤免疫抑制微环境,未来需通过多学科合作、开发联合治疗策略以进一步推动临床转化。随着技术迭代与成本降低,新抗原免疫治疗有望从个体化探索迈向广谱应用,成为癌症综合治疗的重要策略。
Neoantigens,serving as immune targets generated by tumor-specific mutations,possess the core advantages of absence in normal tissues and high immunogenicity,leading a new paradigm for precision immunotherapy in solid tumors.Treatment strategies based on neoantigens primarily include two main directions:Adoptive cell therapy and vaccines.In the field of cell therapy,neoantigen-reactive T cell(NRT)and engineered TCR-T cell therapy have demonstrated durable anti-tumor activity in gastric cancer,cholangiocarcinoma,and breast cancer.In the field of neoantigen vaccines,personalized peptide vaccines and mRNA vaccines have demonstrated promising results due to their rapid development and safety advantages,significantly reducing postoperative recurrence risks in malignancies like melanoma and gastric cancer,and extending survival in advanced solid tumors when combined with immune checkpoint inhibitors.Current challenges in neoantigen immunotherapy focus on prediction accuracy of neoantigens,tumor heterogeneity,in vivo delivery efficiency,and the immunosuppressive tumor microenvironment in solid tumors.Future progress requires multidisciplinary collaboration and the development of combination therapeutic strategies to further promote clinical translation.With technological advancement and cost reduction,neoantigen immunotherapy is expected to move from individualized exploration to broad-spectrum application,becoming a pillar of comprehensive cancer treatment.
作者
刘芹
刘宝瑞
LIU Qin;LIU Baorui(Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Institute of Clinical Oncology,Nanjing University,Jiangsu Nanjing 210008,China)
出处
《现代肿瘤医学》
2026年第1期1-6,共6页
Journal of Modern Oncology
基金
“十四五”江苏省医学重点学科(编号:ZDXK 202233)。
