免疫疗法调节肿瘤微环境治疗肝细胞癌的研究进展

Advances in immunotherapy to modulate tumor microenvironment for hepatocellular carcinoma

近年来,阿替丽珠单抗联合贝伐珠单抗已经取代索拉菲尼成为肝细胞癌一线治疗方案,让我们意识到免疫疗法特别是免疫检查点抑制剂疗法在肝细胞癌治疗中具有广阔的前景。肿瘤微环境是肝细胞癌进展迅速的场所,缺氧、血管生成、酸化、炎症及免疫抑制状态是其特征,从而促进肿瘤发生、发展及转移。而免疫检查点抑制剂疗法可以通过调节肿瘤微环境,抑制促进肿瘤进展的因素,重新唤醒免疫细胞,控制肿瘤进展,延长晚期肝细胞癌患者生存期。本综述致力于阐明肝细胞癌肿瘤微环境的特征,并由此分析免疫检查点抑制剂疗法单用或联合其他疗法通过靶向肿瘤微环境提高肝细胞癌治疗疗效的有效性和可行性。

In recent years,Atelelizumab in combination with Bevacizumab has replaced Sorafenib as the first-line treatment option for hepatocellular carcinoma,making us realize that immunotherapy,especially immune checkpoint inhibitor therapy,has unlimited prospects in the treatment of hepatocellular carcinoma.Tumor microenvironment is the site of rapid progression of hepatocellular carcinoma.Hypoxia,angiogenesis,acidification,inflammation and immunosuppressive state are the characteristics of tumor microenvironment,which promote tumor occurrence,development and metastasis.Immune checkpoint inhibitor therapy can prolong the survival of patients with advanced hepatocellular carcinoma by regulating the tumor microenvironment,inhibiting factors that promote tumor progression,reawakening immune cells,controlling tumor progression,and prolonging the survival of patients with advanced hepatocellular carcinoma.This review aimed to characterize the tumor microenvironment of hepatocellular carcinoma and thus analyze the effectiveness and feasibility of immune checkpoint inhibitor therapy alone or in combination with other therapies to improve the efficacy of hepatocellular carcinoma treatment by targeting the tumor microenvironment.