影响癌症免疫检查点阻断药物治疗疗效和耐药的相关因素分析

发布时间：2018-03-01 23:04

  本文关键词： 免疫检查点阻断药物 疗效 耐药 肿瘤相关因素 非肿瘤相关因素　出处：《肿瘤防治研究》2017年08期 　论文类型：期刊论文

【摘要】：免疫治疗可以在晚期癌症患者身上引起比常规化疗更大的持续应答,然而,这一应答仅发生在相对少部分患者身上。免疫治疗的阳性反应通常依赖于肿瘤细胞与肿瘤微环境(TME)内免疫调节的相互作用,同时受到肿瘤细胞自身及宿主因素的影响。影响免疫检查点阻断药物(ICB)疗效的肿瘤相关因素包括突变负荷、致癌信号、DNA MMR缺陷的影响、死亡前细胞应激和损伤相关分子模式、PD-L1的表达等因素;非肿瘤相关因素主要包括外周和肿瘤内淋巴细胞、病毒等因素。影响ICB耐药的肿瘤相关因素主要包括代谢、表观遗传沉默趋化因子分泌、Ⅰ型干扰素信号转导、肠道微生物、慢性感染、年龄、吸烟史等。多种策略的联合使用,是未来的治疗趋势,通常会提高疗效,但同时也可能增加毒性。
[Abstract]:Immunotherapy can cause sustained response, greater than the conventional chemotherapy in advanced cancer patients. However, this response occurs only in a relatively small part of the patients. The positive reaction of immunotherapy usually depend on tumor cells and tumor microenvironment (TME) interactions in immune regulation, and also affected by tumor cells self and host factors. The influence of immune checkpoint blocking drugs (ICB) tumor related factors including the effect of mutation load, carcinogenic effects of DNA signal, MMR defect, before the death of cell stress and damage associated molecular patterns, the expression of PD-L1 and other factors; related factors of non tumor including peripheral lymphocytes and tumor virus, etc. factors. Factors affecting ICB resistant tumors including metabolism, epigenetic silencing chemokine secretion, type I interferon signal transduction, intestinal microflora, chronic infection, age, smoking history Combined use of a variety of strategies is a future trend of treatment, which usually improves the efficacy, but it may also increase toxicity.

【作者单位】： 湖北省肿瘤医院胸部肿瘤内科一病区;黄冈市中医医院肿瘤科;
【分类号】：R730.51
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本文编号：1553950