Cancer Institute Gustave-Roussy, Villejuif/Paris-Sud 94800, France.
Ann Oncol. 2012 Sep;23 Suppl 8:viii53-7. doi: 10.1093/annonc/mds264.
Increased understanding of cellular and molecular tumour immunology over the past two decades has enabled the identification of new and innovative ways to manipulate the immune response to cancer, with recent phase III trials in patients with metastatic melanoma and hormone-resistant prostate cancer providing proof-of-principle that immunotherapies can improve survival. Based on these successes, many new immunotherapies are being developed, including vaccines and other agents that prime or boost the immune system, T-cell modulatory agents, agents that enhance innate immunity and agents designed to inhibit immunosuppression within the tumour microenvironment. Current experience suggests that immunotherapies are a promising foundation to build treatment regimens for a variety of tumour types. Because many approaches target the immune system and not the cancer, immunotherapies are being evaluated in almost every tumour type, including those that were not previously considered likely to respond to immune manipulation. Immunotherapies also have potential for durable and adaptable cancer control at different stages of disease, including those with early-stage disease and low tumour burdens. To maximise benefits, however, it is likely that combination regimens with conventional cancer treatments or other immunotherapies will be necessary. In addition, the identification of biomarkers will allow further optimisation from a mechanistic and a patient selection perspective. Further advances in research will necessitate multidisciplinary collaboration among physicians, basic and translational researchers and the pharmaceutical industry to ensure that immuno-oncology becomes a cornerstone element in the development of cancer therapy.
在过去的二十年中，对细胞和分子肿瘤免疫学的深入了解使人们能够识别出新的、创新的方法来操纵针对癌症的免疫反应，最近在转移性黑色素瘤和激素难治性前列腺癌患者中的 III 期临床试验提供了证据，证明免疫疗法可以提高生存率。基于这些成功，许多新的免疫疗法正在开发中，包括疫苗和其他能够引发或增强免疫系统的药物、T 细胞调节剂、增强先天免疫的药物以及旨在抑制肿瘤微环境中免疫抑制的药物。目前的经验表明，免疫疗法是为各种肿瘤类型构建治疗方案的有前途的基础。由于许多方法针对免疫系统而不是癌症，因此免疫疗法正在几乎每种肿瘤类型中进行评估，包括以前认为不太可能对免疫干预产生反应的肿瘤类型。免疫疗法也有可能在疾病的不同阶段进行持久和适应性的癌症控制，包括早期疾病和低肿瘤负荷的阶段。然而，为了最大限度地发挥效益，可能需要将常规癌症治疗或其他免疫疗法联合使用。此外，生物标志物的鉴定将从机制和患者选择的角度进一步优化。进一步的研究进展需要医生、基础和转化研究人员以及制药行业之间的多学科合作，以确保肿瘤免疫学成为癌症治疗发展的基石。
