Wargo Jennifer A, Reuben Alexandre, Cooper Zachary A, Oh Kevin S, Sullivan Ryan J
Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX; Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
Semin Oncol. 2015 Aug;42(4):601-16. doi: 10.1053/j.seminoncol.2015.05.007. Epub 2015 Jun 3.
There have been significant advances in cancer treatment over the past several years through the use of chemotherapy, radiation therapy, molecularly targeted therapy, and immunotherapy. Despite these advances, treatments such as monotherapy or monomodality have significant limitations. There is increasing interest in using these strategies in combination; however, it is not completely clear how best to incorporate molecularly targeted and immune-targeted therapies into combination regimens. This is particularly pertinent when considering combinations with immunotherapy, as other types of therapy may have significant impact on host immunity, the tumor microenvironment, or both. Thus, the influence of chemotherapy, radiation therapy, and molecularly targeted therapy on the host anti-tumor immune response and the host anti-host response (ie, autoimmune toxicity) must be taken into consideration when designing immunotherapy-based combination regimens. We present data related to many of these combination approaches in the context of investigations in patients with melanoma and discuss their potential relationship to management of patients with other tumor types. Importantly, we also highlight challenges of these approaches and emphasize the need for continued translational research.
在过去几年中，通过使用化疗、放疗、分子靶向治疗和免疫治疗，癌症治疗取得了重大进展。尽管有这些进展，但单一疗法或单一治疗方式仍有显著局限性。人们越来越有兴趣将这些策略联合使用；然而，目前尚不完全清楚如何最好地将分子靶向治疗和免疫靶向治疗纳入联合治疗方案。在考虑与免疫治疗联合使用时，这一点尤为相关，因为其他类型的治疗可能会对宿主免疫、肿瘤微环境或两者产生重大影响。因此，在设计基于免疫治疗的联合治疗方案时，必须考虑化疗、放疗和分子靶向治疗对宿主抗肿瘤免疫反应和宿主抗宿主反应（即自身免疫毒性）的影响。我们在黑色素瘤患者的研究背景下展示了与许多这些联合治疗方法相关的数据，并讨论了它们与其他肿瘤类型患者管理的潜在关系。重要的是，我们还强调了这些方法的挑战，并强调了持续进行转化研究的必要性。
