Fang Tonglei, Xiao Junyuan, Zhang Yiran, Hu Haiyan, Zhu Yueqi, Cheng Yingsheng
Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Quant Imaging Med Surg. 2021 Jun;11(6):2837-2860. doi: 10.21037/qims-20-173.
Recent progress in immunotherapy provides hope of a complete cure to cancer patients. However, recent studies have reported that only a limited number of cancer patients with a specific immune status, known as "cold tumor", can benefit from a single immune agent. Although the combination of immune agents with different mechanisms can partially increase the low response rate and improve efficacy, it can also result in more side effects. Therefore, discovering therapies that can improve tumors' response rate to immunotherapy without increasing toxicity for patients is urgently needed. Tumor interventional therapy is promising. It mainly includes transcatheter arterial chemoembolization, ablation, radioactive particle internal irradiation, and photodynamic interventional therapy based on a luminal stent. Interventional therapy can directly kill tumor cells by targeted drug delivery , thus reducing drug dosage and systemic toxicity like cytokine release syndrome. More importantly, interventional therapy can regulate the immune system through numerous mechanisms, making it a suitable choice for immunotherapy to combine with. In this review, we provide a brief description of immunotherapies (and their side effects) on tumors of different immune types and preliminarily elaborate on interventional therapy mechanisms to improve immune efficacy. We also discuss the progress and challenges of the combination of interventional therapy and immunotherapy.
免疫疗法的最新进展为癌症患者带来了完全治愈的希望。然而,最近的研究报告称,只有有限数量具有特定免疫状态(即“冷肿瘤”)的癌症患者能够从单一免疫制剂中获益。尽管不同机制的免疫制剂联合使用可部分提高低反应率并改善疗效,但也会导致更多副作用。因此,迫切需要发现既能提高肿瘤对免疫疗法的反应率又不会增加患者毒性的治疗方法。肿瘤介入治疗颇具前景。它主要包括经导管动脉化疗栓塞、消融、放射性粒子内照射以及基于腔内支架的光动力介入治疗。介入治疗可通过靶向给药直接杀死肿瘤细胞,从而减少药物剂量和细胞因子释放综合征等全身毒性。更重要的是,介入治疗可通过多种机制调节免疫系统,使其成为与免疫疗法联合使用的合适选择。在本综述中,我们简要介绍了针对不同免疫类型肿瘤的免疫疗法(及其副作用),并初步阐述了提高免疫疗效的介入治疗机制。我们还讨论了介入治疗与免疫疗法联合应用的进展和挑战。