Cornelissen R, Heuvers M E, Maat A P, Hendriks R W, Hoogsteden H C, Aerts J G J V, Hegmans J P J J
Department of Pulmonary Medicine, Erasmus Medical Center-Daniel den Hoed Cancer Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Clin Dev Immunol. 2012;2012:927240. doi: 10.1155/2012/927240. Epub 2012 Jun 24.
Treatment options for malignant mesothelioma are limited, and the results with conventional therapies have been rather disappointing to this date. Chemotherapy is the only evidence-based treatment for mesothelioma patients in good clinical condition, with an increase in median survival of only 2 months. Therefore, there is urgent need for a different approach to battle this malignancy. As chronic inflammation precedes mesothelioma, the immune system plays a key role in the initiation of this type of tumour. Also, many immunological cell types can be found within the tumour at different stages of the disease. However, mesothelioma cells can evade the surveillance capacity of the immune system. They build a protective tumour microenvironment to harness themselves against the immune system's attacks, in which they even abuse immune cells to act against the antitumour immune response. In our opinion, modulating the immune system simultaneously with the targeting of mesothelioma tumour cells might prove to be a superior treatment. However, this strategy is challenging since the tumour microenvironment possesses numerous forms of defence strategies. In this paper, we will discuss the interplay between immunological cells that can either inhibit or stimulate tumour growth and the challenges associated with immunotherapy. We will provide possible strategies and discuss opportunities to overcome these problems.
恶性间皮瘤的治疗选择有限，迄今为止，传统疗法的效果相当令人失望。化疗是唯一经循证医学证实对临床状况良好的间皮瘤患者有效的治疗方法，中位生存期仅延长2个月。因此，迫切需要一种不同的方法来对抗这种恶性肿瘤。由于慢性炎症先于间皮瘤出现，免疫系统在这类肿瘤的发生过程中起着关键作用。此外，在疾病的不同阶段，肿瘤内可发现多种免疫细胞类型。然而，间皮瘤细胞能够逃避免疫系统的监视。它们构建了一个保护性的肿瘤微环境来抵御免疫系统的攻击，甚至利用免疫细胞来对抗抗肿瘤免疫反应。我们认为，在靶向间皮瘤肿瘤细胞的同时调节免疫系统可能是一种更优的治疗方法。然而，由于肿瘤微环境具有多种防御策略，这种策略具有挑战性。在本文中，我们将讨论可抑制或刺激肿瘤生长的免疫细胞之间的相互作用以及免疫治疗相关的挑战。我们将提供可能的策略并讨论克服这些问题的机会。
