胰腺癌免疫微环境特点与相关免疫治疗策略

Characteristics of pancreatic ductal adenocarcinoma immune microenvironment and related immunotherapy strategies

胰腺导管腺癌是常见的消化道恶性肿瘤之一,具有隐匿性强、侵袭性强、易转移、耐受放化疗的特点,故其5年生存率极其低(<8%)。寻找全新的治疗方法是目前改善胰腺导管腺癌预后的迫切需要。近年来,针对免疫检查点抑制剂、重要抗原的单克隆抗体以及免疫细胞治疗等多种方法治疗胰腺导管腺癌的临床试验大量开展,令人失望的是尚未取得满意的临床获益。胰腺癌癌巢的特殊微环境使得免疫治疗并不像其他恶性肿瘤发挥预期的效果。本文详细介绍了胰腺癌抑制性免疫微环境特点以及不同类型的免疫疗法国内外的最新临床研究,并从免疫微环境特点出发分析联合治疗机制与潜力。

Pancreatic ductal adenocarcinoma is one of the common malignant tumors of the digestive tract.It has the characteristics of strong occlusion,aggressiveness,easy metastasis,and resistance to radiotherapy and chemotherapy.Therefore,its five-year survival rate is extremely low,with a rate of less than 8%.Looking for a new treatment is an urgent need to improve the prognosis of pancreatic ductal adenocarcinoma.In recent years,a large number of clinical trials have been carried out,such as immune checkpoint inhibitors,monoclonal antibodies to important antigens,and immune cell therapy.However,it is disappointing that no satisfactory clinical benefits have been achieved.The special microenvironment of pancreatic cancer nests makes immunotherapy not as effective as other malignant tumors.This article introduces the characteristics of the suppressive immune microenvironment of pancreatic cancer and the latest clinical studies of different types of immunotherapy at home and abroad,and analyzes the mechanisms and potentials of combined treatment based on the characteristics of the immune microenvironment.