结直肠癌免疫治疗中应用PD-1/PD-L1阻断剂的研究进展

Research progress of PD-1/PD-L1 blocker in immunotherapy of colorectal cancer

程序性死亡受体1及其配体(PD-1/PD-L1)位点可抑制免疫细胞等发挥其功能,尤其在肿瘤患者中,PD-1表达数量明显增多,近几年用于很多晚期肿瘤的治疗,均取得了一定的疗效,但在结直肠癌中反映一直不理想,尤其是错配修复基因精确型(pMMR)患者。其影响因素还包括局部免疫微环境中相关物质,如β2-微球蛋白等,可能对疾病的治疗及预后起指导作用。本文总结了目前结直肠癌免疫治疗的临床证据,并回顾了目前临床面临的挑战和新的治疗方法,发现一些联合治疗及局部免疫微环境的改善可能对该肿瘤的免疫疗法有所帮助。

Programmed death receptor 1 and its ligand(PD-1/PD-L1)check point can inhibit the function of immune cells,especially in patients with tumor,the number of PD-1 expression increased significantly.In recent years,PD-1 has been used in the treatment of many advanced tumors,and has achieved certain effect,but it has not been ideal in colorectal cancer,especially in patients with the precise mismatch repair gene(pMMR).The influence factors also include related substances in the local immune microenvironment,such asβ2-microprotein,which may play a role in the treatment and prognosis of the disease.This paper summarizes the clinical evidence of immunotherapy for colorectal cancer,reviews the current clinical challenges and new treatment methods,and it is found that some combination therapy and improvement of local immune microenvironment may be helpful for immunotherapy of this tumor.