精准医疗与肿瘤免疫治疗伴随诊断

Precision medicine and companion diagnostics for tumor immunotherapy

以免疫检查点阻断疗法为代表的肿瘤免疫治疗在肿瘤临床治疗中取得了突破性进展,然而肿瘤免疫治疗伴随诊断仍存在诸多困难。在当前精准医疗大发展的背景下,创新性的技术和方法不断应用到肿瘤免疫治疗的伴随诊断中,对于提高肿瘤免疫治疗的效率具有重要意义。现有研究发现肿瘤微环境PD-L1的表达检测、肿瘤突变和肿瘤变异新抗原分析、肿瘤微环境免疫相关基因表达谱分析等方法与肿瘤免疫治疗效果具有显著相关性,然而其临床应用仍具有一定局限性,导致精准的肿瘤免疫治疗伴随诊断仍面临诸多挑战。主要介绍了免疫检查点阻断治疗相关伴随诊断领域研究进展,提出肿瘤免疫治疗伴随诊断需要开放式思维,积极引入新技术新方法,拓展多元化分子标识,从而推动肿瘤免疫治疗实现个体化精准应用。

Tumor immunotherapy,exemplified by immune checkpoint blockade therapy,has achieved clinical success in treatment of multiple malignant tumors in recent years.However,tumor immunotherapy’s companion diagnostics is still challenging.In the era of precision medicine,innovative technologies and methods should be applied to companion diagnostics for tumor immunotherapy,which would contribute to improve the effi ciency of companion diagnostics.Multiple factors including PD-L1 expression in tumor microenvironment,mutational burden and neoantigen load,immune related gene expression profi les in tumor microenvironment,etc.,are found to be correlated with effi cacy of tumor immunotherapy.Yet,limited clinical application of these factors as pathways for more precise companion diagnostics poses clear blockades for the improvement of precision medicine in tumor immunotherapy.This paper reviewed most recent progresses in the fi eld of companion diagnostics in cancer immune checkpoint blockade therapy.In order to promote precision medicine for tumor immunotherapy,future development of predictive measurements in tumor immunotherapy’s companion diagnostics deserves creative approaches involving more innovative technologies and diversifi ed biomarkers that predict individual benefi ts under specifi c treatments.Key words:tumor immunotherapy