Department of Immunology, Mayo Clinic, Jacksonville, FL, 32224, USA.
Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, 249203, India.
Mol Cancer. 2023 Feb 1;22(1):23. doi: 10.1186/s12943-023-01720-2.
Cancer remains a leading cause of death worldwide, placing a significant burden on healthcare systems as well as the global economy. Rare cancers comprise a group of about 200 cancers that individually occur at extremely low frequencies. In the United States (US), their frequency is approximately 15 cases per 100,000 people, and it is even lower in Europe with approximately 6 cases per 100,000 people. However, combined their frequency of occurrence is much higher than any singular cancer. Cancer treatment and management has tremendously improved in the last decade, particularly with the administration of immune-based therapies. The four most prevalent immune-based therapies are (1) the use of immune-checkpoint inhibitors, (2) macrophage therapy, (3) Chimeric Antigen Receptor (CAR) T cell therapy, and (4) neoantigen-based therapies. In our review, we discuss these various aproaches and their implementation in the treatment of a variety of rare cancers. Furthermore, we discuss their limitations and potential strategies to overcome them to enhance the therapeutic efficacy of these approaches. Finally, our article presents the future directions and other additional immune therapies that may be incorporated into the treatment of rare cancers.
癌症仍然是全球主要的死亡原因，给医疗保健系统和全球经济带来了巨大的负担。罕见癌症包括一组约 200 种癌症，每种癌症的发病率都极低。在美国，其发病率约为每 10 万人 15 例，在欧洲甚至更低，约为每 10 万人 6 例。然而，它们的综合发病率远高于任何一种单一的癌症。在过去的十年中，癌症的治疗和管理取得了巨大的进展，特别是免疫疗法的应用。四种最常见的免疫疗法是：（1）使用免疫检查点抑制剂，（2）巨噬细胞疗法，（3）嵌合抗原受体（CAR）T 细胞疗法，和（4）基于新抗原的疗法。在我们的综述中，我们讨论了这些不同的方法及其在治疗各种罕见癌症中的应用。此外，我们还讨论了它们的局限性和潜在的克服策略，以提高这些方法的治疗效果。最后，我们的文章提出了未来的方向和可能纳入罕见癌症治疗的其他额外免疫疗法。
