「Article Reading」肿瘤免疫治疗

Abstract | In the past decade, advances in the use of monoclonal antibodies (mAbs) and adoptive cellular therapy to treat cancer by modulating the immune response have led to unprecedented responses in patients with advanced-stage tumours that would otherwise have been fatal. To date, three immune-checkpoint-blocking mAbs have been approved in the USA for the treatment of patients with several types of cancer, and more patients will benefit from immunomodulatory 免疫调节 mAb therapy in the months and years ahead. Concurrently, the adoptive transfer of genetically modified lymphocytes to treat patients with haematological 血液学的 malignancies has yielded dramatic results, and we anticipate that this approach will rapidly become the standard of care for an increasing number of patients. In this Review, we highlight the latest advances in immunotherapy and discuss the role that it will have in the future of cancer treatment, including settings for which testing combination strategies and ‘armoured 装甲的’ CAR T cells are recommended. Conclusions The remarkable clinical results observed in trials investigating immunotherapy since 2010 have generated a large amount of interest in this therapeutic modality. Clinical trials using checkpoint blockade inhibitors to treat patients with metastatic melanoma and NSCLC, and trials using CAR T cells to treat relapsed 复发 or refractory 难治的 B-ALL have demonstrated that treating cancer ‘indirectly’ by acting on the immune system can yield durable disease control in patients with malignancies previously thought to be uniformly fatal. We have focused on mAbs and CAR T‑cell therapy, but a number of other modalities of immunotherapy also offer great hope. These include immunomodulatory small molecules, oncolytic 溶瘤 viruses, vaccines, and tumour-targeting mAbs, as well as attempts to overcome T‑cell exclusion, and to exploit the immunomodulatory potential of chemotherapy and radiation therapy. The efficacy of these methods can be complementary to that of the technologies discussed here. Conceptualizing 概念化 which tumour types are most likely to respond to different immunotherapies by categorizing those tumours according to their neoantigen 肿瘤抗原 presentation ability and their microenvironment will help investigators choose the appropriate combinations of immunotherapy for each particular cancer; and with the ongoing advances in precision medicine 精准医学, to facilitate personalized therapeutic selection for each patient.