临床肿瘤免疫治疗研究进展

Clinical tumor immunotherapy: research advances

人类免疫功能低下易导致肿瘤发生,而免疫监视和免疫逃逸机制为肿瘤免疫生物治疗提供了细胞学基础。从免疫系统中T淋巴细胞角度来看,需要从提高免疫功能、有效识别肿瘤细胞和消除抑制性因素三个方面入手,提高细胞毒性T淋巴细胞攻击肿瘤细胞的作用。本文通过分析临床治疗案例,从上述三个方面对细胞因子和免疫修饰治疗、瘤细胞裂解物接种(瘤苗接种)、T细胞基因修饰回输及结合化疗等多种生物治疗的Ⅰ～Ⅲ期临床应用情况进行了总结。并对消除T细胞抑制的信号通路、靶向肿瘤微环境和肿瘤免疫基因治疗进行了分析,以期对肿瘤生物治疗和免疫治疗提供参考和指导。

Human immunosuppression may cause tumor. The knowledge on immune surveillance and tumor immune escape mechanisms provides the cytological basis for tumor immunotherapy, the biological treatment. Focused on T lymphocytes, there are three strategies to improve the ability of those cytotoxic lymphocytes to attack the tumor ceils ： improving the immune function, impro- ving their recognition to cancer cells, and eliminating the inhibitory factors to them. Based on the analysis of the clinical therapy cases, a variety of biological events including cytokine therapy, immune-modified therapy, tumor cell lysates vaccination （tumor vaccine ino- culation）, ex vivo of gene-modified T cells, and others combined with chemotherapy or immune factor treatment are summrized. And the schematic applications on the elimination of T suppressor in different signaling pathways, targeting tumor microenvironment and tumor immune gene therapy are reviewed as well, in hope of providing information and guidances to tumor immunotherapy.