实体瘤免疫治疗非典型反应类型的研究进展

Progression of atypical response in solid tumor immunotherapy

免疫检查点抑制剂(ICIs)的使用彻底改变了晚期肿瘤的治疗模式。目前,美国食品药品监督管理局(FDA)已批准多种ICIs应用于临床,包括抗细胞毒性T淋巴细胞相关抗原4(CTLA-4)单抗、抗程序性死亡受体1(PD-1)及其配体(PD-L1)单抗等。与传统化疗及靶向治疗的应答不同,免疫治疗常伴随着非典型应答反应的出现,如假性进展、超进展、分离反应以及持久反应等。这些非典型反应给临床实践中免疫治疗疗效评价带来挑战,临床医师需定期监测和评价患者的治疗效果,并根据病情变化来优化治疗方案。本文就目前免疫治疗的非典型反应类型作一综述,为临床医师确定抗肿瘤免疫应答反应提供参考。

The use of immunecheckpoint inhibitors(ICIs)has completely changed the treatment mode of advanced cancer.At present,U.S.Food and Drug Administration(FDA)has approved various ICIs for clinical application,including cytotoxic T-lymphocyte associated antigen-4(CTLA-4),programmed death-1(PD-1)and its ligand(PD-L1),etc.Different from the responses of traditional chemotherapy and targeted therapy,immunotherapy is often accompanied by atypical responses,such as pseudoprogression,hyperprogression disease(HPD),dissociated responses,durable response and etc.These atypical reactions bring challenges to the evaluation of the efficacy of immunotherapy in the clinical practice.Clinicians need to regularly monitor and evaluate the treatment effect of patients,and optimize the treatment plan according to the changes of the disease.In this paper,we reviewed the atypical responses of immunotherapy at present,which provided reference for clinicians to distinguish the anti-tumor immune responses.