基于肿瘤免疫微环境的免疫治疗策略在晚期肾透明细胞癌中的应用进展

Progress in the application of immunotherapy strategies based on tumor immune microenvironment in advanced renal clear cell carcinoma

近期的临床研究结果显示,仍有大量晚期肾透明细胞癌(ccRCC)患者对免疫检查点抑制剂(ICIs)无反应。提高ccRCC患者免疫治疗反应是当前迫切的临床需求。靶向不同的肿瘤免疫微环境成分成为克服晚期ccRCC免疫治疗耐药性和优化治疗策略的突破点。本文概述晚期ccRCC免疫治疗面临的挑战,并总结基于肿瘤免疫微环境的新型免疫治疗策略,包括靶向其他共抑制分子和共刺激分子、改良细胞因子疗法、小分子免疫调节剂、靶向免疫代谢和癌症疫苗等。

Recent clinical studies have found that there are still a large number of patients who do not respond to immune checkpoint inhibitors(ICIs).Improving immunotherapy response in ccRCC patients is an urgent clinical need.Targeting different components of the tumor immune microenvironment becomes a breakthrough point for overcoming the immunotherapy resistance and optimizing therapeutic strategies in advanced ccRCC.Several novel immunotherapeutic strategies are currently under clinical investigation,including targeting other co-inhibitory and co-stimulatory molecules,modified cytokine therapies,small-molecule immunomodulators,targeting immune metabolism,and cancer vaccines,each of which target different immunomodulatory pathways in the tumor immune microenvironment for the treatment of ccRCC.In this paper,we provide an overview of the current challenges faced by immunotherapy for advanced ccRCC and review novel immunotherapy strategies based on the tumor immune microenvironment.