中国实用外科杂志 ›› 2024, Vol. 44 ›› Issue (12): 1435-1440.DOI: 10.19538/j.cjps.issn1005-2208.2024.12.23

• 文献综述 • 上一篇    

胰腺癌免疫治疗现状与展望

贾    岚,杨加琦,白雪莉,梁廷波   

  1. 浙江大学医学院附属第一医院肝胆胰外科 全省胰腺病研究重点实验室,浙江杭州 310003
  • 出版日期:2024-12-01 发布日期:2024-12-24

  • Online:2024-12-01 Published:2024-12-24

摘要: 胰腺癌是一种预后极差且治疗手段有限的恶性肿瘤,开展新的治疗策略,延长病人生存迫在眉睫。免疫治疗在诸多实体瘤中已取得显著疗效,但其在胰腺癌中的效果仍有限。胰腺癌的致密基质及高度免疫抑制的肿瘤微环境可能是影响免疫治疗效果的关键因素。逆转胰腺癌免疫抑制状态,重塑肿瘤微环境有望提高免疫治疗的效果。免疫检查点抑制剂与化疗、放疗等的联合治疗已经显示出一定的临床疗效,但尚处于探索阶段。过继细胞治疗、溶瘤病毒及肿瘤疫苗等新型疗法初显潜力,但仍存在局限性。全面解析胰腺癌复杂的肿瘤生态是提升免疫治疗效果的关键。个体化、精准化的联合治疗将是胰腺癌免疫治疗的未来发展方向。

关键词: 胰腺癌, 免疫治疗, 肿瘤疫苗, 过继细胞治疗, 溶瘤病毒

Abstract: Pancreatic cancer presents as an aggressive malignancy with a dismal prognosis and limited therapeutic modalities. It is urgent to develop novel treatment strategies to prolong patient survival. Immunotherapy has demonstrated promising clinical efficacy in various solid tumors in recent years, while its efficacy within the realm of pancreatic cancer treatment is limited. The dense matrix of pancreatic cancer and highly immunosuppressive tumor microenvironment (TME) may be the key factors affecting the effect of immunotherapy. Reversing the immunosuppressive state of pancreatic cancer and remodeling TME are expected to improve the efficacy of immunotherapy. The combination of immune checkpoint inhibitors with chemotherapy or radiotherapy has yielded clinical outcomes to some extent, but it remains in the exploration stages. Concurrently, innovative immunotherapeutic strategies such as adoptive cell therapy, oncolytic viruses, and tumor vaccines have shown potential, yet their application is hindered by various intrinsic limitations. An overall understanding of the complex tumor ecosystem of pancreatic cancer is key to improving the effectiveness of immunotherapy. The future landscape of immunotherapy for pancreatic cancer is anticipated to integrate innovative approaches with a comprehensive and personalized precision medicine paradigm.

Key words: pancreatic cancer, immunotherapy, tumor vaccine, adoptive cell therapy, oncolytic virus