Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas, USA.
Oncologist. 2018 Jan;23(1):71-83. doi: 10.1634/theoncologist.2016-0025. Epub 2017 Sep 21.
Soft tissue and bone sarcomas are a rare and heterogeneous form of cancer. With standard of care treatment options including surgery, radiation, and chemotherapy, the long-term survival is still low for high-risk soft tissue sarcoma patients. New treatment strategies are needed. Immunotherapy offers a new potential treatment paradigm with great promise. Immunotherapy of soft tissue sarcomas dates back to Dr. Coley's first use of toxins in the late 1800s. A variety of strategies of immunotherapy have been tried in soft tissue and bone sarcomas, including various vaccines and cytokines, with limited success. Results of these early clinical trials with vaccines and cytokines were disappointing, but there are reasons to be optimistic. Recent advances, particularly with the use of adoptive T-cell therapy and immune checkpoint inhibitors, have led to a resurgence of this field for all cancer patients. Clinical trials utilizing adoptive T-cell therapy and immune checkpoint inhibitors in soft tissue and bone sarcomas are under way. This paper reviews the current state of evidence for the use of immunotherapy, as well as current immunotherapy strategies (vaccines, adopative T-cell therapy, and immune checkpoint blockade), in soft tissue and bone sarcomas. By understanding the tumor microenviroment of sarcomas and how it relates to their immunoresponsiveness, better immunotherapy clinical trials can be designed, hopefully with improved outcomes for soft tissue and bone sarcoma patients.
Immunotherapy is a promising treatment paradigm that is gaining acceptance for the management of several cancers, including melanoma, renal cell carcinoma, prostate cancer, and lung cancer. There is a long history of immunotherapy in the treatment of soft tissue and bone sarcomas, although with little success. It is important to understand past failures to develop future immunotherapy treatment strategies with an improved possibility of success. This article reviews the history of and current state of immunotherapy research in the treatment of soft tissue and bone sarcomas, with particular regard to vaccine trials, adoptive T-cell therapy, and immune checkpoint blockade.
软组织和骨肉瘤是一种罕见且异质性的癌症。在标准治疗方案中，包括手术、放疗和化疗，高危软组织肉瘤患者的长期生存率仍然较低。需要新的治疗策略。免疫疗法提供了一种新的潜在治疗模式，具有很大的潜力。软组织肉瘤的免疫疗法可以追溯到 19 世纪末 Coley 博士首次使用毒素。在软组织和骨肉瘤中尝试了各种免疫疗法策略，包括各种疫苗和细胞因子，但收效甚微。这些早期临床试验中疫苗和细胞因子的结果令人失望，但有理由感到乐观。最近的进展，特别是使用过继 T 细胞疗法和免疫检查点抑制剂，为所有癌症患者重新激发了这一领域的研究。在软组织和骨肉瘤中利用过继 T 细胞疗法和免疫检查点抑制剂的临床试验正在进行中。本文综述了免疫疗法的现有证据状态，以及当前在软组织和骨肉瘤中使用的免疫疗法策略（疫苗、过继 T 细胞疗法和免疫检查点阻断）。通过了解肉瘤的肿瘤微环境及其与免疫反应性的关系，可以设计更好的免疫疗法临床试验，希望能改善软组织和骨肉瘤患者的预后。
免疫疗法是一种有前途的治疗模式，已被广泛接受用于治疗多种癌症，包括黑色素瘤、肾细胞癌、前列腺癌和肺癌。在软组织和骨肉瘤的治疗中，免疫疗法有着悠久的历史，但收效甚微。了解过去的失败，对于开发未来免疫疗法治疗策略具有重要意义，以期提高成功率。本文综述了软组织和骨肉瘤治疗中免疫疗法的历史和现状，特别关注了疫苗试验、过继 T 细胞疗法和免疫检查点阻断。
