Clinical Research Division, Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Divisions of Medical Oncology and Molecular Medicine, Departments of Medicine and Pathology, University of Washington, Seattle, WA, USA.
Int Immunol. 2019 Jul 13;31(7):465-475. doi: 10.1093/intimm/dxz012.
Among all tumor types, skin cancers are profoundly sensitive to immunotherapy. Indeed, the recently reported response rates for anti-PD-1 (anti-programmed-death 1) therapy for cutaneous malignant melanomas (MM), Merkel cell carcinomas, basal cell carcinomas, cutaneous squamous cell carcinomas and Kaposi sarcomas are all above 40%. This unique immunogenicity renders skin cancers as a paradigm for tumor-immune interactions and is driven by high mutational burdens, over-expressed tumor antigens and/or viral antigens. However, despite the clear demonstration of immunologic cure of skin cancer in some patients, most tumors develop either early (primary) or late (adaptive) resistance to immunotherapy. Resistance mechanisms are complex, and include contributions of tumor cell-intrinsic, T cell and microenvironment factors that have been recently further elucidated with the advent of single-cell technologies. This review will focus on the exciting progress with immunotherapy for skin cancers to date, and also our current understanding of the mechanisms of resistance to immunotherapy.
在所有肿瘤类型中,皮肤癌对免疫疗法具有显著的敏感性。事实上,最近报道的抗 PD-1(程序性死亡受体 1)治疗皮肤恶性黑色素瘤(MM)、默克尔细胞癌、基底细胞癌、皮肤鳞状细胞癌和卡波西肉瘤的反应率均高于 40%。这种独特的免疫原性使皮肤癌成为肿瘤免疫相互作用的典范,这是由高突变负担、过度表达的肿瘤抗原和/或病毒抗原驱动的。然而,尽管在一些患者中明确证实了皮肤癌的免疫治愈,但大多数肿瘤对免疫治疗产生了早期(原发性)或晚期(适应性)耐药性。耐药机制复杂,包括肿瘤细胞内在因素、T 细胞和微环境因素的贡献,随着单细胞技术的出现,这些贡献最近得到了进一步阐明。这篇综述将重点介绍皮肤癌免疫治疗迄今为止取得的令人兴奋的进展,以及我们对免疫治疗耐药机制的现有认识。