基于免疫检查点PD-1的肿瘤免疫耐药机制及耐药后再治疗的策略

Immune Checkpoint PD-1-based Mechanisms of Tumor Immune Resistance and Strategies for Re-treatment After Drug Resistance

免疫治疗被认为是继手术、放疗和化疗后的第四种肿瘤治疗方法。近年来随着对免疫治疗特别是免疫检查点抑制剂研究的深入,PD-1/PD-L1通路抑制剂被批准用于许多癌种的治疗,但由于肿瘤细胞通过多种耐药机制规避免疫应答,免疫检查点阻断存在整体应答率低、原发或继发性耐药等难题。本文阐述了肿瘤免疫耐药的机制,探讨了耐药后再治疗的策略,为提高免疫检查点抑制剂的应答率、降低免疫耐药发生的概率提供理论和临床依据。

Immunotherapy is considered as the fourth cancer treatment after surgery,radiotherapy and chemotherapy.With the in-depth research on immunotherapy in recent years,especially immuno-checkpoint inhibitors,PD-1/PD-L1 pathway inhibitors have been approved for the treatment of many cancer species.But due to the immune response of tumor cells through multiple drug-resistant mechanisms,immuno-checkpoint blockade has some problems,such as low overall response rate,primary or secondary drug resistance and so on.This paper expounds the mechanism of tumor immune resistance and explores strategies for further treatment after drug resistance,which provides a new theoretical and clinical basis for improving the response rate of immune checkpoint inhibitors and reducing the probability of immune resistance.