摘要
结直肠肿癌(CRC)是常见且致死率高的消化系统肿瘤之一,预后较差。免疫检查点抑制药(ICI)通过增强肿瘤微环境(TME)中免疫细胞对肿瘤细胞的杀伤发挥抗肿瘤作用。尽管ICI在血液肿瘤和部分实体肿瘤病人中已取得较为理想的疗效,但在CRC尤其是转移型CRC(mCRC)中响应率较低。TME中存在的多重物理屏障和免疫抑制因素是ICI的疗效被削弱的关键因素,探索ICI与靶向TME的治疗策略的联合治疗方案对解决ICI在CRC中的低响应率有重要临床意义。本文就CRC的TME特征、ICI在CRC中的应用现状和局限性、靶向TME的ICI增效和获益泛化研究现状作一综述,为精准肿瘤免疫治疗的深入发展提供线索和方向。
The colorectal cancer(CRC)is one of the most common and life-threatening gastrointestinal tumors.The prognostic outcomes of CRC remain to be poor.Immune checkpoint inhibitors(ICI)boost the defence of tumor cells by immune cells in the tumor microenvironment(TME)and thus,exerting anti-tumor effects.Despite that ICI have shown promising benefits in patients with hematologic neoplasms and some solid tumors,the response rate and effectiveness of ICI in patients with CRC,especially metastatic CRC(mCRC)remain low.Multiple physical barriers and immunosuppressive factors in TME are the key factors attenuating the efficacy of ICI.Exploring the combined treatment with ICI targeting TME is of great clinical significance to elevate the response rates of ICI in CRC.The present article is aimed to review the characterization of TME in CRC,the application and limitation of ICI in CRC and the status in research of strategies aimed to synergize and generalize the benefit of ICIs targeting TME.This article provides the clues and direction for the further development of accurate anti-tumor immunotherapies.
作者
张雯婷
胡楠
ZHANG Wen-ting;HU Nan(Tumor Biological Diagnosis and Treatment Center,The Third Affiliated Hospital of Soochow University,Changzhou 213003,Jiangsu Province,China;Department of Pharmacy,The Third Affiliated Hospital of Soochow University,Changzhou 213003,Jiangsu Province,China;Jiangsu Engineering Research Center for Tumor Immunotherapy,Changzhou 213003,Jiangsu Province,China;Institute of Cell Therapy,Soochow University,Changzhou 213003,Jiangsu Province,China;Asthma and Bronchitis Research Center,Changzhou 213003,Jiangsu Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2023年第10期1500-1504,共5页
The Chinese Journal of Clinical Pharmacology
基金
国家自然科学基金青年基金资助项目(81801493)
中国博士后科学基金第70批面上基金资助项目(2021M700546)
常州市卫生健康青苗人才基金资助项目(2020105)。
关键词
结直肠肿瘤
肿瘤微环境
免疫检查点抑制药
免疫肿瘤学
colorectal cancer
tumor microenvironment
immune checkpoint inhibitor
immuno-oncology
