Trapani Joseph A, Darcy Phillip K
Aust Fam Physician. 2017;46(4):194-199.
For 50 years, cancer physicians have relied on just three primary treatment modalities: surgery, radiation therapy and chemotherapy. Over that time, enormous progress has been made in understanding cancer biology, targeted anti-cancer drugs have emerged, and thousands of clinical trials have taught us how best to craft treatment combinations that improve clinical outcomes. Only five years ago, a fourth and radically different form of therapy finally emerged: immune‑based cancer therapies.
This review briefly outlines the history and theoretical framework underpinning cancer immunotherapy, and recent progress on several immunotherapeutic approaches.
Immune-based cancer therapies are already revolutionising the management of several types of hitherto intractable cancer, while offering immense hope that the burden of personal suffering and community cost due to cancer will diminish appreciably over the coming decades. At least two immunotherapeutic approaches, checkpoint inhibition and cellular therapy with autologous ('self') chimeric antigen receptor T cells (CAR T cells), now show indisputable evidence of efficacy in several cancer types, and promise yet more rapid progress as they are refined and we learn to combine them with existing conventional therapies and each other.
五十年来，肿瘤内科医生一直依赖三种主要治疗方式：手术、放射疗法和化疗。在此期间，人们对癌症生物学的理解取得了巨大进展，靶向抗癌药物应运而生，数千项临床试验让我们了解了如何制定最佳治疗组合以改善临床疗效。就在五年前，第四种截然不同的治疗方式终于出现：基于免疫的癌症疗法。
本综述简要概述了癌症免疫治疗的历史和理论框架，以及几种免疫治疗方法的最新进展。
基于免疫的癌症疗法已经在改变几种迄今难以治疗的癌症的治疗方式，同时带来了巨大的希望，即未来几十年，癌症给个人带来的痛苦和社会成本负担将大幅减轻。至少有两种免疫治疗方法，即检查点抑制和自体（“自身”）嵌合抗原受体T细胞（CAR T细胞）的细胞疗法，现在已在几种癌症类型中显示出无可争议的疗效证据，并且随着它们的不断完善以及我们学会将它们与现有的传统疗法相互结合，有望取得更快的进展。
