Woodall Matthew J, Neumann Silke, Campbell Katrin, Pattison Sharon T, Young Sarah L
Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand.
Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand.
Cancers (Basel). 2020 May 14;12(5):1230. doi: 10.3390/cancers12051230.
Cancer is one of the leading causes of morbidity and mortality worldwide. Traditional treatments include surgery, chemotherapy and radiation therapy, and more recently targeted therapies including immunotherapy are becoming routine care for some cancers. Immunotherapy aims to upregulate the patient's own immune system, enabling it to destroy cancerous cells. Obesity is a metabolic disorder characterized by significant weight that is an important contributor to many different diseases, including cancers. Obesity impacts the immune system and causes, among other things, a state of chronic low-grade inflammation. This is hypothesized to impact the efficacy of the immunotherapies. This review discusses the effects of obesity on the immune system and cancer immunotherapy, including the current evidence on the effect of obesity on immune checkpoint blockade, something which currently published reviews on this topic have not delved into. Data from several studies show that even though obesity causes a state of chronic low-grade inflammation with reductions in effector immune populations, it has a beneficial effect on patient survival following anti-PD-1/PD-L1 and anti-CTLA-4 treatment. However, research in this field is just emerging and further work is needed to expand our understanding of which cancer patients are likely to benefit from immunotherapy.
癌症是全球发病和死亡的主要原因之一。传统治疗方法包括手术、化疗和放疗，最近包括免疫疗法在内的靶向治疗正成为一些癌症的常规治疗手段。免疫疗法旨在上调患者自身的免疫系统，使其能够摧毁癌细胞。肥胖是一种代谢紊乱，其特征是体重显著超标，是包括癌症在内的许多不同疾病的重要促成因素。肥胖会影响免疫系统，并导致慢性低度炎症等状况。据推测，这会影响免疫疗法的疗效。本综述讨论了肥胖对免疫系统和癌症免疫疗法的影响，包括目前关于肥胖对免疫检查点阻断作用的证据，而目前已发表的关于该主题的综述尚未深入探讨这一点。多项研究的数据表明，尽管肥胖会导致慢性低度炎症状态并使效应免疫细胞群体减少，但它对抗PD-1/PD-L1和抗CTLA-4治疗后的患者生存率有有益影响。然而，该领域的研究刚刚起步，需要进一步开展工作，以加深我们对哪些癌症患者可能从免疫疗法中获益的理解。
