Department of Otolaryngology - Head and Neck Surgery, National University Health System, Singapore.
Department of Otolaryngology - Head and Neck Surgery, National University Health System, Singapore; Department of Otolaryngology, National University of Singapore, Singapore.
Oral Oncol. 2018 Sep;84:61-70. doi: 10.1016/j.oraloncology.2018.07.011. Epub 2018 Jul 20.
Undifferentiated Nasopharyngeal carcinoma (NPC) is ubiquitously identified with the Epstein-Barr virus (EBV), making this cancer a suitable candidate for cellular-based immunotherapy (CBI) due to its expression of potentially targetable tumor-associated viral antigens. Various preclinical and clinical studies have explored the use of cytotoxic T cells (CTLs), tumor-infiltrating lymphocytes (TILs), natural killer (NK) cells, and dendritic cells (DCs) in the treatment of both refractory and locally advanced NPC with some success. Notably, immune-mediated antitumor effects were observed even in heavily pre-treated NPC patients, suggesting potential clinical benefit of CBI in this group of patients. These immune anti-tumor effects may be even more clinically evident when used as a first-line treatment, since there may not be an intense immunosuppressive environment which is typically encountered in refractory cancer patients. Additionally, CBI may exert an effect in priming the immune system and diminishing the cancer's acquired resistance to exert a more robust response to previously failed chemotherapy. Although these results are encouraging, further refinements of clinical protocols to boost anti-tumor response and benefit a larger subset of patients proved necessary. Herein, we aim to review the rational of developing CBI in EBV-induced NPC and summarize its current applications in clinical studies.
未分化鼻咽癌（NPC）普遍被认为与 EBV 有关，这使得这种癌症成为细胞免疫疗法（CBI）的合适候选者，因为它表达了潜在可靶向的肿瘤相关病毒抗原。各种临床前和临床研究已经探索了使用细胞毒性 T 细胞（CTL）、肿瘤浸润淋巴细胞（TIL）、自然杀伤（NK）细胞和树突状细胞（DC）治疗难治性和局部晚期 NPC 的效果，取得了一定的成功。值得注意的是，即使在经过大量预处理的 NPC 患者中也观察到了免疫介导的抗肿瘤作用，这表明 CBI 在这组患者中具有潜在的临床益处。当作为一线治疗时，这些免疫抗肿瘤作用在临床上可能更为明显，因为通常在难治性癌症患者中遇到的强烈免疫抑制环境可能不存在。此外，CBI 可能会发挥作用，刺激免疫系统，并减少癌症获得的耐药性，从而对以前失败的化疗产生更强烈的反应。尽管这些结果令人鼓舞，但进一步改进临床方案以增强抗肿瘤反应并使更多的患者受益仍然是必要的。在此，我们旨在回顾开发 EBV 诱导的 NPC 中 CBI 的合理性，并总结其在临床研究中的当前应用。
