Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, Hubertus Wald Comprehensive Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Department of Tumor Biology, Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Semin Immunopathol. 2019 Mar;41(2):251-263. doi: 10.1007/s00281-018-0724-7. Epub 2018 Oct 25.
Cancer represents a leading cause of death with continuously increasing incidence worldwide. Many solid cancer types in non-reproductive organs are significantly more frequent and deadly in males compared to females. This sex-biased difference is also present in hematologic malignancies. In this review, we present an overview about sex differences in cancer with a focus on leukemia. We discuss mechanisms potentially underlying the observed sex-biased imbalance in cancer incidence and outcome including sex hormones, sex chromosomes, and immune responses. Besides affecting the pathobiology of cancers, sex differences can also influence drug responses, most notably those to immune checkpoint blockers. Therefore, sex should become a relevant factor in clinical trial design in order to avoid over- or under-treatment of one sex.
癌症是全球主要致死病因之一，其发病率呈持续上升趋势。非生殖器官的许多实体瘤在男性中的发病率和致死率明显高于女性。这种性别差异在血液系统恶性肿瘤中也同样存在。在这篇综述中，我们概述了癌症中的性别差异，并重点介绍了白血病。我们讨论了潜在的机制，包括性激素、性染色体和免疫反应，这些机制可能导致癌症发病率和结果的性别偏倚失衡。除了影响癌症的病理生物学特性外，性别差异还会影响药物反应，尤其是免疫检查点抑制剂的反应。因此，在临床试验设计中，性别应成为一个相关因素，以避免对某个性别过度或治疗不足。
