Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA.
Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Adv Exp Med Biol. 2021;1342:45-80. doi: 10.1007/978-3-030-79308-1_2.
Immune checkpoint blockade transformed cancer therapy during the last decade. However, durable responses remain uncommon, early and late relapses occur over the course of treatment, and many patients with PD-L1-expressing tumors do not respond to PD-(L)1 blockade. In addition, while some malignancies exhibit inherent resistance to treatment, others develop adaptations that allow them to evade antitumor immunity after a period of response. It is crucial to understand the pathophysiology of the tumor-immune system interplay and the mechanisms of immune escape in order to circumvent primary and acquired resistance. Here we provide an outline of the most well-defined mechanisms of resistance and shed light on ongoing efforts to reinvigorate immunoreactivity.
免疫检查点阻断在过去十年中改变了癌症治疗。然而,持久的反应仍然不常见,在治疗过程中会出现早期和晚期复发,并且许多表达 PD-L1 的肿瘤患者对 PD-(L)1 阻断无反应。此外,虽然一些恶性肿瘤对治疗具有固有抗性,但其他肿瘤在一段时间的反应后会发展出适应性,从而逃避抗肿瘤免疫。了解肿瘤-免疫系统相互作用的病理生理学和免疫逃逸的机制对于规避原发性和获得性耐药至关重要。在这里,我们提供了最明确的耐药机制概述,并阐明了正在努力重新激活免疫反应。