Tsuchiya Nobuhiro, Sawada Yu, Endo Itaru, Uemura Yasushi, Nakatsura Tetsuya
Nobuhiro Tsuchiya, Yasushi Uemura, Tetsuya Nakatsura, Division of Cancer Immunotherapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa 277-8577, Japan.
World J Gastroenterol. 2015 Sep 28;21(36):10314-26. doi: 10.3748/wjg.v21.i36.10314.
Hepatocellular carcinoma (HCC), the predominant form of primary liver cancer, is the fifth most common cancer worldwide and the second leading cause of cancer-related death. Despite the high incidence, treatment options remain limited for advanced HCC, and as a result prognosis continues to be poor. Current therapeutic options, surgery, chemotherapy and radiotherapy, have only modest efficacy. New treatment modalities to prolong survival and to minimize the risk of adverse response are desperately needed for patients with advanced HCC. Tumor immunotherapy is a promising, novel treatment strategy that may lead to improvements in both treatment-associated toxicity and outcome. The strategies have developed in part through genomic studies that have yielded candidate target molecules and in part through basic biology studies that have defined the pathways and cell types regulating immune response. Here, we summarize the various types of HCC immunotherapy and argue that the new-found field of HCC immunotherapy might provide critical advantages in the effort to improve prognosis of patients with advanced HCC. Already several immunotherapies, such as tumor-associated antigen therapy, immune checkpoint inhibitors and cell transfer immunotherapy, have demonstrated safety and feasibility in HCC patients. Unfortunately, immunotherapy currently has low efficacy in advanced stage HCC patients; overcoming this challenge will place immunotherapy at the forefront of HCC treatment, possibly in the near future.
肝细胞癌(HCC)是原发性肝癌的主要形式,是全球第五大常见癌症,也是癌症相关死亡的第二大主要原因。尽管发病率很高,但晚期HCC的治疗选择仍然有限,因此预后仍然很差。目前的治疗选择,手术、化疗和放疗,疗效都很一般。对于晚期HCC患者,迫切需要新的治疗方法来延长生存期并将不良反应风险降至最低。肿瘤免疫疗法是一种有前景的新型治疗策略,可能会改善治疗相关毒性和治疗结果。这些策略部分是通过产生候选靶分子的基因组研究发展而来,部分是通过定义调节免疫反应的途径和细胞类型的基础生物学研究发展而来。在这里,我们总结了HCC免疫疗法的各种类型,并认为新发现的HCC免疫疗法领域可能会在改善晚期HCC患者预后的努力中提供关键优势。已经有几种免疫疗法,如肿瘤相关抗原疗法、免疫检查点抑制剂和细胞转移免疫疗法,在HCC患者中证明了安全性和可行性。不幸的是,免疫疗法目前在晚期HCC患者中的疗效较低;克服这一挑战将使免疫疗法在不久的将来可能处于HCC治疗的前沿。