肿瘤免疫治疗中超进展现象的研究及进展

邢嵘雪; 崔童; 田应选

doi:10.16766/j.cnki.issn.1674-4152.002869

肿瘤免疫治疗中超进展现象的研究及进展

doi: 10.16766/j.cnki.issn.1674-4152.002869

邢嵘雪^{1, 2},
崔童²,
田应选^1, ,

1.
陕西省人民医院呼吸内二科，陕西西安 710068
2.
西安医学院研究生处，陕西西安 710021

基金项目:

陕西省人民医院拔尖人才支持计划项目 2021BJ-22

详细信息

通讯作者:
田应选，E-mail：tian-tyx@163.com

中图分类号: R730.51
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- 被引次数: 0
出版历程
- 收稿日期: 2022-02-23
- 网络出版日期: 2023-04-20

Research and progress of hyperprogression after immunotherapy

1.
Department of Respiratory Medicine, Shaanxi Provincial People' s Hospital, Xi' an, Shaanxi 710068, China

摘要

摘要: 现代免疫治疗作为癌症治疗的新里程碑，为许多缺乏有效治疗方法的肿瘤治疗带来了颠覆性的变革。在过去十年中，由于对分子水平适应性免疫的认识和理解，促进了免疫检查点抑制剂药物的开发。以帕博利珠单抗、纳武利尤单抗为代表的免疫检查点抑制剂是一种全新的治疗模式，不同于传统的化疗或分子水平精准治疗的靶向治疗，其通过对自体免疫细胞及肿瘤免疫微环境的调节作用促使自体免疫细胞发挥强大的抗肿瘤作用，在众多临床试验和真实世界研究中都展现出了不俗的表现，明显的生存获益、更低的治疗不良反应发生率、接受治疗患者生存质量改善，使其成为众多晚期实体瘤治疗中的一颗新星，为多种类型的实体瘤治疗带来了新希望，是众多晚期肿瘤患者的新福音。但随着其使用的普及，有临床医师发现部分患者在免疫治疗中非但没有显著的生存获益，反而出现了短时间内肿瘤快速进展，甚至迅速死亡的情况，这一现象被称为免疫治疗超进展。目前，关于超进展现象出现的机制和临床应对策略的研究相当有限。本文拟从定义、临床特征、发生机制、鉴别诊断及患者管理这几个方面进行综述，以期使临床医师在治疗中尽早识别超进展现象，及时采取措施，改善晚期肿瘤患者预后，带来生存获益。
- 免疫治疗 /
- 免疫检查点抑制剂 /
- 超进展 /
- 发生机制 /
- 患者管理
Abstract: As a new milestone in cancer treatment, modern immunotherapy has brought subversive changes to many tumour treatments that lack effective treatment methods. In the past decade, given our knowledge and understanding of adaptive immunity at the molecular level, the development of immune checkpoint inhibitor drugs has been promoted. Immune checkpoint inhibitors such as pembrolizumab and nivolumab are a brand-new treatment model, which is different from traditional chemotherapy or targeted therapy of molecular-level precision therapy. In addition, the regulation of tumour immune microenvironment promotes autoimmune cells to exert powerful anti-tumour effects. It has shown excellent performance in many clinical trials and real-world studies. The significant evident survival benefits, lower incidence of treatment adverse reactions and improved quality of life of patients receiving treatment have indicated its importance in the treatment of many advanced solid tumours. It brings new hope for the treatment of various types of solid tumours, and is a new boon for many patients with advanced tumours. However, with the popularity of its use, some clinicians have found that instead of significant survival benefit in immunotherapy, some patients experienced rapid tumour progression and even rapid death in a short period of time. This phenomenon is known as immunotherapy hyperprogression. At present, the research on the mechanism of hyperprogression and clinical strategies is quite limited. This article aims to review the definition, clinical features, mechanism of occurrence, differential diagnosis and patient management to identify the hyperprogression phenomena as early as possible during treatment and take timely measures to improve the prognosis of patients with advanced cancer and bring survival benefits.
- Immunotherapy /
- Immune-checkpoint inhibitors /
- Hyperprogressive disease /
- Mechanism of occurrence /
- Patient management

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