晚期胃癌免疫检查点PD-1/PD-L1抑制剂联合治疗的研究进展

Research progress on immune checkpoint PD-1/PD-L1 inhibitor combination therapy for advanced gastric cancer

胃癌是最为常见的恶性肿瘤之一,在中国其发病率和死亡率均较高,大多数胃癌初诊即已为晚期,预后较差,目前治疗现状仍不理想。免疫逃逸是肿瘤发生发展的一主要机制,细胞程序性死亡受体-1(programmed death-1,PD-1)及细胞程序性死亡配体(programmed death-ligand 1,PD-L1)是导致免疫逃逸的重要分子,PD-1与PD-L1结合是肿瘤细胞免疫逃逸的重要发病机制之一,特异性阻断二者结合,可达到杀灭肿瘤细胞的目的。PD-1/PD-L1抑制剂可明显改善晚期胃癌患者预后,并且PD-1/PD-L1抑制剂联合化疗、靶向治疗、放疗等可进一步提高疗效。本文就PD-1/PD-L1抑制剂联合治疗在晚期胃癌中的治疗进展进行综述。

Gastric cancer is one of the most common malignant tumors with high morbidity and mortality in our country.By the time of their initial diagnosis,most gastric cancers progress to the advanced stage,and consequently,have poor prognoses.Moreover,the treat-ment status is not optimistic.Immune escape is a major mechanism of tumorigenesis and tumor development.Programmed death-1(PD-1)and programmed death-ligand 1(PD-L1)are substantial for facilitating immune escape,and their combination is an important pathogenesis mechanism in tumor cell immune escape.Thus,one method to kill tumor cells is by blocking this combination.Many clinical trials have demonstrated that PD-1/PD-L1 inhibitors can significantly improve the prognosis of patient with advanced gastric cancer.Furthermore,the treatment efficacy can be improved by combining PD-1/PD-L1 inhibitors with chemotherapy,targeted therapy,and radiotherapy.This article reviews the research progress on PD-1/PD-L1 inhibitor combination therapy for advanced gastric cancer.