进展期胃癌免疫治疗的研究进展

Advances in immunotherapy for advanced gastric cancer

目的了解进展期胃癌免疫治疗的最新研究进展。方法检索近年来国内外有关进展期胃癌免疫治疗研究的相关文献并进行综述。结果进展期胃癌免疫治疗主要集中于免疫检查点抑制剂、细胞免疫和抗肿瘤疫苗3个方面,研究最多的是免疫检查点抑制剂,尤其是针对程序性死亡蛋白-1/程序性死亡蛋白配体1、细胞毒性T淋巴细胞相关抗原4和淋巴细胞激活基因3的研究较多,细胞免疫治疗和肿瘤疫苗治疗研究相对较少。虽然免疫治疗单药并没有特别良好的表现,但其治疗效果不劣于单独化学药物治疗且不良反应发生率低,而且采用免疫联合治疗在大多数试验中展现出良好的临床疗效,尤其在与抗人表皮生长因子受体2抗体的联合应用中临床获益明显,靶向Claudin 18.2位点的嵌合抗原受体T细胞在胃癌中已初见成效。结论随着免疫治疗研究的深入,胃癌免疫治疗的策略也在不断改进,免疫治疗过程中精准医学愈发显得重要,针对精准的靶点筛选适宜的患者及采用精准治疗手段可进一步让进展期胃癌患者生存获益。

Objective To recognize the latest research progress of immunotherapy for advanced gastric cancer(AGC).Method The domestic and international literature on immunotherapy for AGC in recent years were retrieved and reviewed.Results The immunotherapy for AGC mainly focused on immune checkpoint inhibitors(ICIs),cellular immunity,and antitumor vaccines.The most immunotherapy researched was ICIs,especially for programmed death protein-1/programmed death protein ligand 1,cytotoxic T lymphocyte associated antigen 4,and lymphocyte activating gene 3.The cellular immunotherapy and tumor vaccine therapy were less relatively.Although immunotherapy alone did not have a particularly good effect,its therapeutic effect was not inferior to that of chemotherapy alone and the incidence of adverse reactions was lower.Moreover,most studies had concluded that the use of immunotherapy in combination with other therapy had shown a good clinical efficacy,especially in combination with anti-human epidermal growth factor receptor 2 antibody,and chimeric antigen receptor T cells targeting Claudin 18.2 site had promising results in the AGC.Conclusions With the development of immunotherapy research,the strategies of immunotherapy for AGC are also constantly improving.Precision medicine is important in the process of immunotherapy.Targeted screening suitable patients and adopting precise treatment can further benefit the survival of patients with AGC.