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化疗对改善胰腺癌肿瘤微环境的临床影响。

Clinical impact of chemotherapy to improve tumor microenvironment of pancreatic cancer.

作者信息

Tsuchikawa Takahiro, Takeuchi Shintaro, Nakamura Toru, Shichinohe Toshiaki, Hirano Satoshi

机构信息

Takahiro Tsuchikawa, Shintaro Takeuchi, Toru Nakamura, Toshiaki Shichinohe, Satoshi Hirano, Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.

出版信息

World J Gastrointest Oncol. 2016 Nov 15;8(11):786-792. doi: 10.4251/wjgo.v8.i11.786.

Abstract

A perioperative multimodal strategy including combination chemotherapy and radiotherapy, in addition to surgical resection, has been acknowledged to improve patient prognosis. However chemotherapy has not been actively applied as an immunomodulating modality because of concerns about various immunosuppressive effects. It has recently been shown that certain chemotherapeutic agents could modify tumor microenvironment and host immune responses through several underlying mechanisms such as immunogenic cell death, local T-cell infiltration and also the eradication of immune-suppressing regulatory cells such as regulatory T cells (Tregs) and myeloid-derived suppressor cells. With the better understanding of the cell components in the tumor microenvironment and the effect of chemotherapy to improve tumor microenvironment, it has been gradually clear that the chemotherapeutic agents is two-edged sword to have both immune promoting and suppressing effects. The cellular components of the tumor microenvironment include infiltrating T lymphocytes, dendritic cells, regulatory T cells, tumor associated macrophages, myeloid derived suppressor cells and cancer associated fibroblasts. Based on the better understanding of tumor microenvironment following chemotherapy, the treatment protocol could be modified as personalized medicine and the prognosis of pancreas cancer would be more improved utilizing multimodal chemotherapy. Here we review the recent advances of chemotherapy to improve tumor microenvironment of pancreatic cancer, introducing the unique feature of tumor microenvironment of pancreatic cancer, interaction between anti-cancer reagents and these constituting cells and future prospects.

摘要

除手术切除外,包括联合化疗和放疗的围手术期多模式策略已被公认可改善患者预后。然而,由于担心各种免疫抑制作用,化疗尚未作为一种免疫调节方式得到积极应用。最近有研究表明,某些化疗药物可通过多种潜在机制改变肿瘤微环境和宿主免疫反应,如免疫原性细胞死亡、局部T细胞浸润以及清除免疫抑制调节细胞,如调节性T细胞(Tregs)和髓系来源的抑制细胞。随着对肿瘤微环境中细胞成分以及化疗改善肿瘤微环境作用的深入了解,化疗药物作为具有免疫促进和抑制双重作用的双刃剑已逐渐明晰。肿瘤微环境的细胞成分包括浸润性T淋巴细胞、树突状细胞、调节性T细胞、肿瘤相关巨噬细胞、髓系来源的抑制细胞和癌症相关成纤维细胞。基于对化疗后肿瘤微环境的更好理解,治疗方案可作为个性化医疗进行调整,利用多模式化疗可进一步改善胰腺癌的预后。在此,我们综述化疗改善胰腺癌肿瘤微环境的最新进展,介绍胰腺癌肿瘤微环境的独特特征、抗癌药物与这些构成细胞之间的相互作用以及未来前景。

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