摘要
目的总结放射治疗联合PD-1/PD-L1抑制剂在晚期乳腺癌中的临床研究,探讨联合治疗用于晚期乳腺癌时所面临的挑战和机遇,为进一步提高晚期乳腺癌治疗效果提供研究线索和方向。方法应用PubMed及中国知网数据库检索系统,以“晚期乳腺癌、放射治疗、免疫检查点抑制剂、PD-1/PD-L1抑制剂”等为关键词,检索2012-01-2022-10发表的相关文献。共检索到英文文献213条,中文文献43条。纳入标准:(1)放射治疗联合免疫检查点抑制剂的作用机制;(2)放疗联合PD-1/PD-L1抑制剂在晚期乳腺癌中的相关研究;(3)联合治疗用于晚期乳腺癌时所面临的挑战和机遇。排除标准:非放射治疗、免疫治疗等与本研究关联性较小文章。最终共纳入45篇文献进行分析。结果临床前研究显示,放疗联合PD-1/PD-L1抑制剂具有协同增效作用;临床试验结果显示,两者联合是安全的,较传统治疗有一定疗效优势,但联合模式尚无定论;多项探讨联合方式的单臂和随机对照研究正在进行当中。结论放疗联合PD-1/PD-L1抑制剂治疗晚期乳腺癌虽已初见疗效,但仍面临着作用机制、放射剂量、分割模式、治疗顺序以及联用多种免疫检查点抑制剂等诸多问题的挑战。
Objective To review the clinical studies of radiotherapy combined with programmed death receptor 1/programmed death receptor-ligand 1(PD-1/PD-L1)inhibitors in advanced breast cancer,and to discuss the challenges and opportunities faced by this research strategy,in order to provide research clues and directions for further improving therapeutic effect for advanced breast cancer.Methods PubMed database and China National Knowledge Infrastructure(CNKI)were used to search the relevant literature with the keywords of"advanced breast cancer,radiotherapy,immune checkpoint inhibitors,PD-1/PD-L1 inhibitors"from January 2012 to October 2022.A total of 213 English literatures and 43 Chinese literatures were retrieved.Inclusion criteria:The mechanism of radiotherapy combined with immune checkpoint inhibitor;The clinical studies of radiotherapy combined with PD-1/PD-L1 inhibitors in advanced breast cancer.Exclusion criteria:Non-related literatures such as non-radiotherapy and non-immunotherapy.Finally,45 articles were included in the analysis.Results Radiotherapy combined with PD-1/PD-Ll inhibitor has synergistic effect.The combination is safe and has certain advantages over traditional treatment,but the combination mode is still inconclusive.Multiple single-arm and randomized controlled trials are still in the process.ConclusionA lthough radiotherapy combined with PD-1/PD-L1 inhibitor has shown initial efficacy in the treatment of advanced breast cancer,it faces many challenges,such as joint mechanism,radiation dose,fractionation mode,treatment sequence,and combination of more PD-1/PD-L1 inhibitors.
作者
李晨阳
刘秋芳
王天昶
田甜
刘昕
张曼西
LI Chenyang;LIU Qiufang;WANG Tianchang;TIAN Tian;LIU Xin;ZHANG Manxi(First Department of Radiotherapy,Shaanzi Cancer Hospital,Xian 710061,China;Gredualte School,Xi'an Modical College.Xi'an 710068.China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第7期436-442,共7页
Chinese Journal of Cancer Prevention and Treatment
基金
2021年陕西省卫健委扶植项目(2021DD035)
陕西省一般项目-社会发展领域(2022SF-461)。
