摘要
目的世界范围内,头颈部鳞状细胞癌(head and neck squamous cell carcinoma,HNSCC)发病率在恶性肿瘤中居第7位,复发转移性(recurrent or metastatic,R/M)HNSCC生活质量下降,治疗方法少,预后差。近年来,以免疫检查点抑制剂为代表的免疫治疗取得突破性进展,成为黑色素瘤、肺癌等多种肿瘤有效的治疗选择。本研究对R/M HNSCC免疫治疗的现状和进展作一综述。方法以"头颈鳞癌,免疫治疗,免疫检查点抑制剂,过继T细胞治疗,肿瘤疫苗"等为关键词,应用PubMed和CNKI期刊全文数据库检索系统以及ClinicalTrials.gov网站,检索2001-01-2017-01的相关文献及注册临床研究,共检索到英文文献138篇,中文文献84篇。纳入标准:(1)R/M HNSCC;(2)免疫治疗现状及进展;(3)免疫治疗相关临床研究。共纳入38篇文献进行分析。结果 R/M HNSCC中免疫治疗研究广泛开展并逐渐深入,尤其是免疫检查点抑制剂。程序性细胞死亡1(programmed cell death-1,PD-1)抑制剂(Pembrolizumab和Nivolumab)显示出明显疗效,因此被食品药品管理局(food and drug administration,FDA)批准用于R/M HNSCC的治疗。尽管其他免疫检查点抑制剂如程序性死亡配体1(programmed death ligand-1,PD-L1)抑制剂(Durvalumab和Avelumab)和细胞毒T淋巴细胞相关抗原4(cytotoxic T lymphocyte-associated antigen-4,CTLA-4)抑制剂(Ipilimumab和Tremelimumab)尚无Ⅲ期临床研究结果发表来证明其确切疗效,但有一系列临床研究正在进行中。过继T细胞治疗和肿瘤疫苗的免疫治疗模式也在探索中。此外,在R/M HNSCC免疫治疗中根据生物标志物筛选有效患者,联合治疗提高疗效以及不良反应的监测及治疗等方面也被关注。结论 R/M HNSCC中免疫治疗有良好前景,但也存在许多挑战,如何筛选免疫治疗最有效的人群、探索免疫治疗模式及提高疗效仍是未来研究重点。
OBJECTIVE Head and neck squamous cell carcinoma （HNSCC） is the seventh most common cancer worldwide. Recurrent or metastatic （R/M） HNSCC have rare treatment methods with poor prognosis. Recently, immu- notherapy, especially immune checkpoint inhibitors, has make great breakthrough in solid tumors such as melanoma and lung cancer. This review was to summarize the current status and perspectives of immunotherapy in R/M HNSCC. METHODS Two hundred and twenty-two related papers and clinical trails were searched with ＂head and neck squamous cell carcinoma, immunotherapy, immune checkpoint inhibitors, adoptive cell transfer, tumor vaccine＂ as key words with- in PubMed or CNKI database retrieval system and ClinicalTrials. gov website from January 2001 to January 2017, and 38 were finally selected according to the inclusion criteria as follows： （1） R/M HNSCC; （2） current status and future per- spective of immunotherapy; （3） immunotherapy related clinical trials. RESULTS Researches of immunotherapy in R/M HNSCC immunotherapy have developed wildly and deepened gradually, especially immune checkpoint inhibitors. Pro- grammed cell death-1（PD-1） inhibitors （pembrolizumab and nivolumab） showed obvious effect, and were approved by food and drug administration （FDA） for the treatment of R/M HNSCC. Although there are no results of phase 3 clinical trials related to other immune checkpoint inhibitors, such as programmed death ligand-1 （PD-L1） inhibitors （durvalumab and avelumab） and Cytotoxie T lymphocyte-associated antigen-4 （CTLA-4） inhibitors （ipilimumab and tremelimumab） published, a series of clinical trials are ongoing. The modes of adoptive cell transfer and tumor vaccine are explored. Be- sides, many aspects of immunotherapy in R/M HNSCC, such as screening patients according to biomarkers, improving efficacy with combination methods, monitoring and treatment of adverse events also catch our attentions. CONCLUSIONS Immunotherapy has a bright prospect in R/M HNSCC, but the
出处
《中华肿瘤防治杂志》
CAS
北大核心
2017年第15期1102-1108,共7页
Chinese Journal of Cancer Prevention and Treatment
关键词
复发转移头颈鳞癌
免疫治疗
免疫检查点抑制剂
过继T细胞治疗
肿瘤疫苗
综述文献
recurrent or metastatic head and neck squamous cell carcinoma
immunotherapy
immune checkpoint in-hihitors
adoptive cell transfer
tumor vaccine~ review literature
