Department of Dermatology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China; School of Medicine, Ningbo University, Ningbo, China.
School of Medicine, Ningbo University, Ningbo, China; Department of Histology and Embryology, Harbin Medical University, Harbin, China.
Int Immunopharmacol. 2022 Jul;108:108803. doi: 10.1016/j.intimp.2022.108803. Epub 2022 May 13.
Immunotherapy is an emerging method for the treatment of cancer. Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that block immune checkpoint pathways and release the body's anti-tumor immunity. They consist mainly of antibodies against cytotoxic T lymphocyte associated antigen-4 (CTLA-4), programmed death receptor 1 (PD-1), and programmed death ligand 1 (PD-L1). Although ICI therapy has been shown to be effective at treating cancer, it can also destroy immune tolerance and lead to organ toxicity. These unwanted side effects are known as immune related adverse events (irAEs). ICI treatment can also cause unconventional reactions such as pseudoprogression and hyperprogression. Pseudoprogression looks like an increase in the tumor parenchyma but is actually a temporary inflammation in the tumor; hyperprogression refers to the acceleration of tumor growth after the start of immunotherapy. Understanding the mechanisms of these two phenomena and distinguishing their differences are necessary for the effective prevention and treatment of unconventional reactions.
免疫疗法是一种新兴的癌症治疗方法。免疫检查点抑制剂（ICI）是一种单克隆抗体，可阻断免疫检查点途径并释放机体的抗肿瘤免疫。它们主要由针对细胞毒性 T 淋巴细胞相关抗原 4（CTLA-4）、程序性死亡受体 1（PD-1）和程序性死亡配体 1（PD-L1）的抗体组成。尽管 ICI 疗法已被证明可有效治疗癌症，但它也可能破坏免疫耐受并导致器官毒性。这些不良的副作用称为免疫相关不良事件（irAEs）。ICI 治疗还可能引起非传统反应，如假性进展和超进展。假性进展看起来像是肿瘤实质的增加，但实际上是肿瘤内的暂时炎症；超进展是指免疫治疗开始后肿瘤生长的加速。了解这两种现象的机制并区分它们的差异，对于有效预防和治疗非传统反应是必要的。
