中国实用外科杂志

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肝癌免疫生物治疗的现状及评价

朱    迎,钦伦秀   

  1. 复旦大学附属华山医院普外科  复旦大学肿瘤转移研究所,上海200040
  • 出版日期:2016-06-01 发布日期:2016-05-31

  • Online:2016-06-01 Published:2016-05-31

摘要:

免疫生物疗法被认为是最有希望的防治肝癌术后复发转移的非手术治疗方法。已发现肝内免疫抑制状态微环境失衡是肝癌病人的特征性表现,纠正这一状态有助于抑制肿瘤进展。逆转免疫应答失衡和免疫抑制的策略包括肿瘤疫苗、细胞因子与细胞疗法、靶向免疫检测点和靶向清除肿瘤相关巨噬细胞(TAM)等。临床试验证实干扰素等细胞因子和辅助性应用细胞因子诱导活化(CIK)细胞疗法可降低复发率、延长生存期。近年来嵌合抗原受体T细胞(CAR-T细胞)疗法和以PD-1/PD-L1和CTLA4等为免疫监测点的免疫新疗法取得突破性进展,为治愈肝癌带来了曙光。联合应用、个体化精准定制、肝癌特异性抗原识别等领域值得关注。

关键词: 肝癌, 免疫治疗, 肿瘤疫苗, 细胞因子活化细胞, 免疫检测点

Abstract:

Recent progress of biological immunotherapy for hepatocellular carcinoma        ZHU Ying,QIN Lun-xiu. Department of General Surgery,Huashan Hospital,Cancer Metastasis Institute,Fudan University,Shanghai 200040,China
Corresponding author:QIN Lun-xiu,E-mail:qinlx@fudan.edu.cn
Abstract    Biological immunotherapy is regarded as the most hopeful therapeutic strategy for hepatocellular carcinoma (HCC),particularly in combating metastatic recurrence after surgical treatments. The liver microenvironment of HCC patients is characterized by a strong immune suppressive activity. Counterbalancing such as immune-suppressive environment with immune stimulatory approaches including cancer vaccines,cytokines and autologous cytokine-induced killer cells,immune-checkpoint blocking antibodies and macrophages is helpful to control HCC. Many clinical trials have demonstrated that interferon and adjuvant cytokine-induced killer cells are useful for decreasing postoperative tumor relapse and prolonging overall survival. In recent years,PD1/PD-L1 inhibitors and chimeric antigen receptor (CAR)-T cells have brought new hopes in the treatment of HCC. It is worth paying attention to the combined application, individualized precision customization, hepatic cancer specific antigen recognition.

Key words: hepatocellular carcinoma, immunotherapy, cancer vaccines, cytokine-induced killer cells, immune checkpoint blockers