儿童癌症的免疫疗法：从生物学理解到临床应用。
Immunotherapy of childhood cancer: from biologic understanding to clinical application.
机构信息
Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Building 10, Room #1-3750, 9000 Rockville Pike, MSC 1104, Bethesda, MD 20892-1104, USA.
出版信息
Curr Opin Pediatr. 2010 Feb;22(1):2-11. doi: 10.1097/MOP.0b013e3283350d3e.
PURPOSE OF REVIEW
Most children with cancer can be cured with combination regimens of chemotherapy, radiation, surgery, or all. However, standard therapies are toxic to normal tissues, cancer cells commonly develop resistance to chemotherapy, and relapsed malignancy is a leading cause of mortality in pediatrics. Elucidation of the principles of the normal immune response and tumor biology, coupled with technological developments, have led to important advances in the field of cancer immunotherapy. This review summarizes the biologic basis of cancer immunotherapy and highlights recent examples of progress in the application of novel humoral and cellular immunotherapies to children and adolescents with malignancy.
RECENT FINDINGS
Clinical trials of immunotherapy for pediatric cancer have recently been initiated. To date, most immune-based therapies have been well tolerated and some have shown clinically significant activity against specific refractory high-risk malignancies.
SUMMARY
Recent clinical trial results provide proof-of-principle that cancer immunotherapy has the capacity to overcome chemotherapy resistance without the usual toxicities associated with cytotoxic regimens. Immunotherapy holds promise in the treatment of children and adolescents with cancer and has the potential to improve both survival and quality of life.
目的综述
大多数癌症患儿可以通过化疗、放疗、手术或联合治疗治愈。然而，标准疗法对正常组织具有毒性，癌细胞通常对化疗产生耐药性，复发性恶性肿瘤是儿科死亡的主要原因。对正常免疫反应和肿瘤生物学原理的阐明，加上技术的发展，使得癌症免疫治疗领域取得了重要进展。本综述总结了癌症免疫治疗的生物学基础，并重点介绍了新型体液和细胞免疫疗法在儿童和青少年恶性肿瘤中的应用的最新进展。
最近的发现
目前已经开始了儿童癌症免疫治疗的临床试验。迄今为止，大多数基于免疫的疗法耐受性良好，并且一些疗法对特定的难治性高危恶性肿瘤具有明显的临床活性。
总结
最近的临床试验结果提供了初步证据，表明癌症免疫疗法具有克服化疗耐药性的能力，而不会产生与细胞毒性方案相关的常见毒性。免疫疗法在治疗儿童和青少年癌症方面具有广阔的前景，并有可能提高生存率和生活质量。
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