黑素瘤免疫治疗的难点及对策

Melanoma immunotherapy:difficulties and strategies

黑素瘤是高度恶性的免疫原性肿瘤,尽管以免疫检查点抑制剂为代表的免疫治疗可显著提高转移性黑素瘤患者的生存率,但仍有近半数患者对免疫治疗产生耐受和抵抗,且免疫相关不良反应发生率高。本文聚焦目前黑素瘤免疫治疗存在的耐受、抵抗及免疫相关不良反应等关键难点,总结相应的对策与研究进展。通过干预黑素瘤免疫抑制性微环境、筛选精准的生物标记物及优化免疫治疗联合策略等能够帮助解决免疫治疗耐受和抵抗的问题,同时传统免疫治疗与纳米技术的结合也可大幅减少免疫相关不良反应的发生。未来,对肿瘤免疫微环境更为广泛和深入的研究将有助于探索黑素瘤免疫治疗的最佳方式。

Melanoma is a highly malignant immunogenic tumor.Although immunotherapy represented by immune checkpoint inhibitors can markedly improve the survival rate of patients with metastatic melanoma,nearly half of patients are still tolerant or resistant to immunotherapy,with high incidence of immune-related adverse reactions.This review focuses on the key difficulties in tolerance,resistance and immune-related adverse reactions to current melanoma immunotherapy,and summarizes corresponding strategies and research advances.By intervening in the immunosuppressive microenvironment in melanoma,screening precise biomarkers,and optimizing immunotherapy-based combination strategies,the problem of tolerance and resistance to immunotherapy can be solved.Moreover,the combination of traditional immunotherapy and nanotechnology can also greatly reduce the occurrence of immune-related adverse reactions.In the future,more extensive and in-depth research on the tumor immune microenvironment will help to explore the best immunotherapy regimens for melanoma.