Peripheral immunity forms the foundation of tumor immunity,while tumor immunity represents a more refined adaptation of peripheral immune responses.The tumor microenvironment(TME),a localized niche surrounding tumor c...Peripheral immunity forms the foundation of tumor immunity,while tumor immunity represents a more refined adaptation of peripheral immune responses.The tumor microenvironment(TME),a localized niche surrounding tumor cells,is inherently immunosuppressive(1,2).Effective tumor therapy necessitates the dismantling of this microenvironment,aiming to eradicate tumors from the host system.展开更多
Immune checkpoint inhibitor(ICI)has limited efficacy in the treatment of immune“cold”tumors.Due to insufficient T cell infiltration and heterogeneous programmed death ligand 1(PD-L1)expression,the ORR is only 5%–8%...Immune checkpoint inhibitor(ICI)has limited efficacy in the treatment of immune“cold”tumors.Due to insufficient T cell infiltration and heterogeneous programmed death ligand 1(PD-L1)expression,the ORR is only 5%–8%compared with 30%–40%of“hot”tumors.This article reviews the synergistic mechanism,clinical efficacy and optimization strategy of oncolytic virus(OVs)combined with ICIs in the treatment of refractory malignant tumors.Systematic analysis of mechanistic interactions across tumor types and clinical trial data demonstrates that OVs transform the immunosuppressive microenvironment by inducing immunogenic cell death and activating innate immunity.Concurrently,ICIs enhance adaptive immunity by reversing T-cell exhaustion and expanding T-cell diversity.Clinical trials in melanoma,head and neck cancer and breast cancer showed superior efficacy.The Objective Response Rate(ORR)of combination therapy was 39%–62%,while the ORR of ICI monotherapy was 18%.Treatment heterogeneity is mainly attributed to virus-related factors,including targeting specificity and replication efficiency,tumor characteristics,such as antigen presenting ability and mutation load,and host immune status,including preexisting antiviral antibodies and microbiome composition.This combined approach represents a paradigm shift in cancer immunotherapy,which effectively transforms immune“cold”tumors into“hot”tumors through the continuous activation of innate and adaptive immune responses.In the future,it is expected to improve the therapeutic effect of treatment-resistant malignant tumors through the integration of immune regulatory molecules,accurate biomarkers to guide the treatment scheme and triple combination strategy by a new generation of engineering viruses.展开更多
目的:探讨经肛直肠全系膜切除术(transanal total mesorectal excision,taTME)治疗低位及超低位直肠癌的临床效果和安全性。方法:回顾性分析行taTME治疗的7例低位及超低位直肠癌患者的临床资料,评价治疗的可行性、安全性和疗效。结果:7...目的:探讨经肛直肠全系膜切除术(transanal total mesorectal excision,taTME)治疗低位及超低位直肠癌的临床效果和安全性。方法:回顾性分析行taTME治疗的7例低位及超低位直肠癌患者的临床资料,评价治疗的可行性、安全性和疗效。结果:7例患者均顺利完成腹腔镜辅助taTME,无中转开腹,3例用管型吻合器行结-直肠端端吻合,经腹经肛门同时手术6例,序贯进行1例,手术时间平均(205.7±104.8)min,术中出血量平均(35.7±31.1)mL;保肛率100%(7/7);3例患者行预防性回肠造口,均于术后3个月行回肠还纳。拔除骶前引流管时间(5.4±3.0)d,术后(9.6±2.4)d出院;吻合口漏2例,无死亡、吻合口狭窄、肠梗阻、切口感染等并发症发生。淋巴结检出数平均为(10.4±2.8)枚,阳性淋巴结(0.7±1.7)枚。结论:taTME技术治疗低位及超低位直肠癌安全可靠。展开更多
文摘Peripheral immunity forms the foundation of tumor immunity,while tumor immunity represents a more refined adaptation of peripheral immune responses.The tumor microenvironment(TME),a localized niche surrounding tumor cells,is inherently immunosuppressive(1,2).Effective tumor therapy necessitates the dismantling of this microenvironment,aiming to eradicate tumors from the host system.
基金supported in part by grants from the National Natural Science Foundation ofChina(Nos.82260462,82460606,32360046)Yunnan Fundamental Research Kunming Medical University Joint Projects(Nos.202201AY0700001-144,202301AY070001-115)+2 种基金Yunnan Fundamental Research Projects(No.202201AT070269)Yunnan health training project of high level talents(Nos.D-2024007,H-2024023)Graduate Innovation Fund of Kunming Medical University(No.2025S100).
文摘Immune checkpoint inhibitor(ICI)has limited efficacy in the treatment of immune“cold”tumors.Due to insufficient T cell infiltration and heterogeneous programmed death ligand 1(PD-L1)expression,the ORR is only 5%–8%compared with 30%–40%of“hot”tumors.This article reviews the synergistic mechanism,clinical efficacy and optimization strategy of oncolytic virus(OVs)combined with ICIs in the treatment of refractory malignant tumors.Systematic analysis of mechanistic interactions across tumor types and clinical trial data demonstrates that OVs transform the immunosuppressive microenvironment by inducing immunogenic cell death and activating innate immunity.Concurrently,ICIs enhance adaptive immunity by reversing T-cell exhaustion and expanding T-cell diversity.Clinical trials in melanoma,head and neck cancer and breast cancer showed superior efficacy.The Objective Response Rate(ORR)of combination therapy was 39%–62%,while the ORR of ICI monotherapy was 18%.Treatment heterogeneity is mainly attributed to virus-related factors,including targeting specificity and replication efficiency,tumor characteristics,such as antigen presenting ability and mutation load,and host immune status,including preexisting antiviral antibodies and microbiome composition.This combined approach represents a paradigm shift in cancer immunotherapy,which effectively transforms immune“cold”tumors into“hot”tumors through the continuous activation of innate and adaptive immune responses.In the future,it is expected to improve the therapeutic effect of treatment-resistant malignant tumors through the integration of immune regulatory molecules,accurate biomarkers to guide the treatment scheme and triple combination strategy by a new generation of engineering viruses.
文摘目的:探讨经肛直肠全系膜切除术(transanal total mesorectal excision,taTME)治疗低位及超低位直肠癌的临床效果和安全性。方法:回顾性分析行taTME治疗的7例低位及超低位直肠癌患者的临床资料,评价治疗的可行性、安全性和疗效。结果:7例患者均顺利完成腹腔镜辅助taTME,无中转开腹,3例用管型吻合器行结-直肠端端吻合,经腹经肛门同时手术6例,序贯进行1例,手术时间平均(205.7±104.8)min,术中出血量平均(35.7±31.1)mL;保肛率100%(7/7);3例患者行预防性回肠造口,均于术后3个月行回肠还纳。拔除骶前引流管时间(5.4±3.0)d,术后(9.6±2.4)d出院;吻合口漏2例,无死亡、吻合口狭窄、肠梗阻、切口感染等并发症发生。淋巴结检出数平均为(10.4±2.8)枚,阳性淋巴结(0.7±1.7)枚。结论:taTME技术治疗低位及超低位直肠癌安全可靠。
