肿瘤精准免疫诊断综合评估

近年来,肿瘤免疫治疗(cancer immunotherapies)已成为晚期恶性肿瘤治疗的重要手段之一。肿瘤免疫治疗并不直接攻击癌细胞,而是通过调节人体自身免疫系统来抗击肿瘤,有望像抗生素改变抗感染治疗一样改变肿瘤治疗范式。抗PD-1/L1和抗CTLA-4抗体药物作为肿瘤免疫治疗的代表药物,使晚期癌症患者五年生存率达成了数倍的提升,被认为是真正有希望治愈癌症的治疗方式。然而,肿瘤免疫治疗只对部分患者有效,并且存在耐药、超进展、不良反应等问题。如何准确筛选出最有可能从治疗中获益的人群成为肿瘤免疫治疗研究中的一个重大挑战。目前有多个与免疫治疗相关的生物标志物正在研究中,并且有望被用于临床筛选治疗获益人群;但这些生物标记物也存在很多缺陷。未来,围绕免疫治疗敏感性和副反应的多项指标综合评估可能成为一个趋势。

Comprehensive Evaluation is needed for Precision Diagnosis in Cancer Immunotherapies

Cancer immunotherapies has become one of the important approaches in advanced malignant tumor treatments. The immunotherapies attack tumors by reinvigorating the human immune system, which will change the paradigm of cancer treatment. The immunotherapies, including anti-PD-1/L1 and anti-CTLA-4 antibodies, have improved the five-year survival rate of patients with malignant tumors, and have been recognized as the most promising treatments to cure cancer. However, only a subset of patients benefits from the immunotherapy, and there are problems such as drug resistance, hyperprogression disease, and immune-related adverse events. Thus, the early selection of the most sensitive patients is key, and the development of predictive biomarkers is one of the biggest challenges of cancer immunotherapy development. Many biomarkers are under investigation, and they are potentially applicable to the clinical selection of patients for immunotherapies, but each has limited utility. Comprehensive evaluation of multiple indicators around the sensitivity and the adverse events of immunotherapies will be the direction of the future. In this article, we will review the research progress in cancer immunotherapies and comprehensive evaluation of precision cancer diagnosis.