Division of Hematology/Oncology, Department of Internal Medicine, Texas Tech University Health Sciences Center , Lubbock, TX , USA.
Int Rev Immunol. 2015 Mar;34(2):134-42. doi: 10.3109/08830185.2015.1018417.
Male-based studies, both at the biochemical and at the pre-clinical/clinical trial levels, still predominate in the scientific community. Many studies are based on the wrong assumption that both sexes are fundamentally identical in their response to treatments. As a result, findings obtained mainly in males are applied to females, resulting in negative consequences female patients. In cancer immunotherapy, there is still a scarce focus on this topic. Here we review the main differences in immune modulation and immune system biology between males and females with a particular focus on how these differences affect cancer immunotherapy and cancer vaccines.
We reviewed articles published on PubMed from 1999 to 2014, using the keywords: sex hormones, immune response, estrogen, immunotherapy, testosterone, cancer vaccines, sex-based medicine. We also present new data wherein the expression of the cancer testis antigen, Ropporin-1, was determined in patients with multiple myeloma, showing that the expression of Ropporin-1 was influenced by sex.
Male and female immune systems display radical differences mainly due to the immune regulatory effects of sex hormones. These differences might have a dramatic impact on the immunological treatment of cancer. Moreover, the expression of tumor antigens that can be targeted by anti-cancer vaccines is associated with sex.
Future clinical trials focusing on cancer immunotherapy will need to take into account the differences in the immune response and in the frequency of target antigen expression between male and females, in order to optimize these anti-cancer immunotherapies of the third millennium.
在科学领域，男性为基础的研究——无论是在生化水平还是在临床前/临床试验水平——仍然占据主导地位。许多研究基于这样一个错误的假设，即两性在对治疗的反应上基本相同。因此，主要在男性中获得的研究结果被应用于女性，导致女性患者出现负面后果。在癌症免疫疗法中，仍然很少关注这一主题。在这里，我们综述了男性和女性在免疫调节和免疫系统生物学方面的主要差异，特别关注这些差异如何影响癌症免疫疗法和癌症疫苗。
我们使用关键词“性激素、免疫反应、雌激素、免疫疗法、睾丸激素、癌症疫苗、基于性别的医学”，在 1999 年至 2014 年间，在 PubMed 上检索发表的文章，并进行了综述。我们还提供了新的数据，其中确定了多发性骨髓瘤患者中癌症睾丸抗原 Ropporin-1 的表达，表明 Ropporin-1 的表达受性别影响。
男性和女性的免疫系统存在显著差异，主要是由于性激素对免疫的调节作用。这些差异可能对癌症的免疫治疗产生重大影响。此外，可被抗癌疫苗靶向的肿瘤抗原的表达与性别有关。
未来专注于癌症免疫疗法的临床试验将需要考虑到男性和女性之间免疫反应和靶抗原表达频率的差异，以优化第三个千年的这些抗癌免疫疗法。
