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[去势抵抗性前列腺癌免疫治疗的新进展]

[New progress of castration-resistant prostate cancer immunotherapy].

作者信息

Liu J P, Wang H

机构信息

Department of Urology, No. 281 Hospital of People's Liberation Army, Qinhuangdao 066100, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2016 Oct 1;54(10):787-791. doi: 10.3760/cma.j.issn.0529-5815.2016.10.015.

Abstract

Prostate cancer, especially castration-resistant prostate cancer (CRPC) with its very poor prognosis, quite difficult treatments and urgent need of new theraputic strategies has become a serious problem of men's health in our country. Recent studies have shown that prostate cancer cells can stimulate the immune response; therefore, immunotherapy has become one of the hot spots in the treatment of CRPC. Cancer vaccines including polypeptide vaccines, nucleic acid vaccines, whole cell vaccines and autologous dendritic cell vaccines have been in stage Ⅱ or Ⅲ clinical trials, and will have good application prospects. Immune checkpoint inhibitors for the treatment of melanoma have got satisfactory results, but for CRPC are lack of systematic researches and the effects remain to be followed-up. Immune modulators for CRPC have shown antitumor activity, but the overall survival of patients was not improved. Existing studies have shown that immunotherapy of CRPC has good prospects, but most drugs are still in the research stage and need a considerable distance before clinical application. The optimal timing of immunotherapy, value of combined administration, evaluation of therapeutic effect, potential immune-based predictive and prognostic biomarkers are to be explored. With the development of tumor immune agents and the accumulation of evidence based medicine, CRPC immunotherapy will be more standard.

摘要

前列腺癌,尤其是去势抵抗性前列腺癌(CRPC),其预后极差、治疗相当困难且迫切需要新的治疗策略,已成为我国男性健康的一个严重问题。最近的研究表明,前列腺癌细胞可以刺激免疫反应;因此,免疫疗法已成为CRPC治疗的热点之一。包括多肽疫苗、核酸疫苗、全细胞疫苗和自体树突状细胞疫苗在内的癌症疫苗已进入Ⅱ期或Ⅲ期临床试验,并有良好的应用前景。用于治疗黑色素瘤的免疫检查点抑制剂已取得令人满意的结果,但对于CRPC缺乏系统研究,其效果仍有待随访。用于CRPC的免疫调节剂已显示出抗肿瘤活性,但患者的总生存期并未得到改善。现有研究表明,CRPC的免疫疗法前景良好,但大多数药物仍处于研究阶段,距离临床应用还有相当长的距离。免疫疗法的最佳时机、联合给药的价值、治疗效果评估、潜在的基于免疫的预测和预后生物标志物都有待探索。随着肿瘤免疫药物的发展和循证医学证据的积累,CRPC免疫疗法将更加规范。

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