Tougeron David, Fauquembergue Émilie, Latouche Jean-Baptiste
CHU de Poitiers, service d'hépato-gastro-entérologie, 2, rue de la Milétrie, 86000 Poitiers cedex, France, Inserm, U1079, faculté de médecine de Rouen, 76000 Rouen Cedex, France, Faculté de médecine de Poitiers, laboratoire inflammation, tissus épithéliaux et cytokines, France.
Bull Cancer. 2013 Sep;100(9):871-85. doi: 10.1684/bdc.2013.1800.
Recent studies have underlined the close link between immune response and prognosis of patients with colorectal cancer (CRC). Immune response understanding combined with biotechnology progress of the last years has allowed development of immunotherapy strategies in CRC. Immunotherapy strategies are divided in "active" or "passive" strategies (patients immune system stimulation or not) and considering the activation of antigen specific immune response or not. These immunotherapy strategies are well tolerated and induced cellular and humoral response correlated with clinical response. Many monoclonal antibodies targeting signalisation pathways or angiogenic growth factors have demonstrated their efficacy in CRC. Multiple vaccine strategies, using different tumour associated antigens, have demonstrated a biological efficacy but with poor clinical results. Results are more promising in adjuvant setting but need to be confirmed by randomized trials. Adoptive immunotherapy with transfer of tumour associated antigen specific T cell is probably the most promising strategy. Actually, except monoclonal antibodies, immunotherapy is not used in clinical practice in CRC due to the lack of results and absence of standardisation.
最近的研究强调了免疫反应与结直肠癌(CRC)患者预后之间的密切联系。对免疫反应的理解,结合过去几年生物技术的进展,使得CRC免疫治疗策略得以发展。免疫治疗策略分为“主动”或“被动”策略(是否刺激患者免疫系统),并考虑是否激活抗原特异性免疫反应。这些免疫治疗策略耐受性良好,可诱导与临床反应相关的细胞和体液反应。许多靶向信号通路或血管生成生长因子的单克隆抗体已在CRC中证明了其疗效。使用不同肿瘤相关抗原的多种疫苗策略已证明具有生物学疗效,但临床结果不佳。在辅助治疗中结果更有前景,但需要通过随机试验来证实。转移肿瘤相关抗原特异性T细胞的过继性免疫治疗可能是最有前景的策略。实际上,除了单克隆抗体外,由于缺乏结果和标准化,免疫治疗在CRC的临床实践中尚未使用。