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[癌症免疫疗法:前景与现实]

[Immunotherapy of cancer: promise and reality].

作者信息

Chouaib Salem, El Hage Faten, Benlalam Houssem, Mami-Chouaib Fathia

机构信息

Laboratoire d'Immunologie des Tumeurs Humaines, Inserm U753, IFR-54, Institut Gustave-Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex, France.

出版信息

Med Sci (Paris). 2006 Aug-Sep;22(8-9):755-9. doi: 10.1051/medsci/20062289755.

Abstract

The notion that the immune system regulates cancer development is now well established. An overwhelming amount of data from animal models, together with compelling data from human patients, indicate that the immune system is instrumental in scanning and irradicating tumors. Analysis of individuals with congenital or acquired immunodeficiencies or patients undergoing immunosuppressive therapy has documented a highly elevated incidence of virally induced malignancies and cancers compared with immunocompetent individuals [1-3]. During the last decade, thanks to the breakthoughts in understanding the molecular mechanisms responsible for immune activation, the tumor antigen identification, the dendritic cell biology, the immunogenecity of tumors, the immune escape mechanisms, the host-tumor relationship, we are facing a new area of tumor immunotherapy. The basic advances were translated in therapeutical applications and have changed the view of immunotherapy from "a dream scenario" to a clinical fourth modality to cancer treatments. Multiple cancer trials using active immunization with vaccines or adoptive immunotherapy have been conducted with only very limited success. There are still a number of issues that still need to be resolved including a better understanding of immune escape mechanisms. Cancer vaccines continue to be evaluated and may lead to the emergence of clinically useful new treatments. A comprehensive approach to define the intricate molecular program initiated by tumor cells to resist to escape and the immune system of the host may help in breaking down the barriers to a more adapted cancer immunotherapy.

摘要

免疫系统调节癌症发展这一观念现已得到充分确立。来自动物模型的大量数据,以及来自人类患者的令人信服的数据表明,免疫系统在扫描和根除肿瘤方面发挥着重要作用。对先天性或获得性免疫缺陷个体或接受免疫抑制治疗的患者的分析表明,与免疫功能正常的个体相比,病毒诱导的恶性肿瘤和癌症的发病率显著升高[1-3]。在过去十年中,由于在理解免疫激活的分子机制、肿瘤抗原识别、树突状细胞生物学、肿瘤免疫原性、免疫逃逸机制、宿主-肿瘤关系等方面取得了突破,我们正面临着肿瘤免疫治疗的新领域。这些基础进展已转化为治疗应用,并将免疫治疗的观点从“理想方案”转变为癌症治疗的临床第四种模式。使用疫苗主动免疫或过继性免疫疗法进行的多项癌症试验仅取得了非常有限的成功。仍有许多问题需要解决,包括更好地理解免疫逃逸机制。癌症疫苗仍在评估中,可能会带来临床上有用的新治疗方法。采用综合方法来定义肿瘤细胞启动的复杂分子程序,以抵抗逃逸和宿主免疫系统,这可能有助于打破障碍,实现更合适的癌症免疫治疗。

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