免疫检查点在胶质母细胞瘤中的研究现状及前景分析

Checkpoints in glioblastoma multiforme:a research progress and prospect analysis

胶质母细胞瘤(GBM)是中枢神经系统(CNS)最常见和侵袭能力最强的原发性恶性脑肿瘤,以手术切除、同步放化疗、辅助化疗为标准治疗方案,但GBM的预后极差.标准治疗方案无法安全、特异地消除所有癌细胞,仅能提供给患者有限的生存获益.故此,有研究试图利用免疫系统天然的细胞杀伤能力,侵略性地对肿瘤发起免疫攻击,即所谓"免疫治疗".近年来,针对免疫检查点的抗体对非小细胞肺癌、肾癌、黑色素瘤、血液系统肿瘤和其他恶性肿瘤产生明显的临床反应,引起了研究人员对调查这些药物在脑肿瘤领域是否有效的兴趣.本文综述目前GBM和免疫检查点的相关知识,评估过去和现在的免疫检查点治疗试验,讨论未来针对免疫检查点治疗的方向,以期为GBM的治疗提供依据.

Glioblastoma is the most common and most invasive primary malignant brain tumor in the central nervous system. Surgical resection, concurrent chemoradiotherapy and adjuvant chemotherapy are the standard treatment options, but the prognosis is very poor. It can be said that the standard treatment cannot safely and specifically eliminate all cancer cells, and only provide patients with limited survival benefits. Therefore, a large number of studies have attempted to use the natural cell killing ability of the immune system to aggressively attack the tumor, which is called "immunotherapy." This treatment concept has spawned a variety of treatment strategies, and is becoming another tumor treatment program after surgery, radiotherapy, chemotherapy and molecular targeted therapy. In recent years, antibodies against immune checkpoints have been shown to produce impressive clinical responses to non-small cell lung cancer, kidney cancer, melanoma, hematological tumors and other malignant tumors; it has raised interest in investigating whether these drugs are also effective in the field of brain tumors. Here, we summarize the current knowledge of central nervous system immune checkpoints and evaluate past and current immunological checkpoint treatment trials. And the future direction of treatment of immune checkpoints is discussed to provide new dawn for patients with malignant glioma.