Institute of Oncology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China.
Laboratory Center, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Cancer Rep (Hoboken). 2024 Sep;7(9):e2134. doi: 10.1002/cnr2.2134.
According to the 2020 statistics from the World Health Organization's International Agency for Research on Cancer (IARC), it is projected that there will be over 1 million new cases of gastric cancer (GC) patients worldwide in 2020, resulting in approximately 770 000 deaths. Gastric cancer ranks fifth in terms of incidence rate and forth in death rate among malignant tumors. Despite advancements in early diagnostic techniques, the incidence of GC has exhibited a marginal decline; nevertheless, the mortality rate remains elevated for advanced inoperable patients with no currently available efficacious treatment options.
Chinese medicine (CM) has emerged as an efficacious treatment for GC, gradually gaining acceptance and widespread usage in China. It exhibits distinctive advantages in the prevention and treatment of metastasis. CM and natural medicine possess the ability to elicit antitumor effects by augmenting immune cell population, enhancing immune cell activity, and improving the tumor immune microenvironment. CMs and natural remedies encompass a diverse range of types, characterized by multiple targets, pathways, and extensive pharmacological effects. Consequently, they have become a prominent research area among oncologists worldwide. Numerous studies have demonstrated that CM and natural medicine can directly or indirectly enhance innate immune system components (including macrophages, natural killer cells, and myeloid suppressor cells), adaptive immune system elements (such as T lymphocytes and regulatory T cells), relevant cytokines (e.g., IL-2, IL-4, IL-10, TNF-α), and PD-1/PD-L1 axis regulation, thereby bolstering the cytotoxicity of immune cells against tumor cells.
This ultimately leads to an improved tumor immune microenvironment facilitating superior antitumor efficacy. This paper critically examines the role of CM and natural medicine in regulating immunotherapy for GC, aiming to establish a new theoretical framework for the clinical treatment and prevention of gastric cancer within the realm of CM.
根据世界卫生组织国际癌症研究机构（IARC）2020 年的统计数据，预计 2020 年全球将有超过 100 万新的胃癌（GC）患者，导致约 77 万人死亡。胃癌在恶性肿瘤的发病率中排名第五，死亡率排名第四。尽管早期诊断技术有所进步，但 GC 的发病率略有下降；然而，对于无法手术的晚期患者，死亡率仍然很高，目前尚无有效的治疗方法。
中医药（CM）已成为治疗 GC 的有效方法，在中国逐渐得到认可和广泛应用。它在防治转移方面具有独特的优势。CM 和天然药物通过增加免疫细胞群体、增强免疫细胞活性和改善肿瘤免疫微环境来发挥抗肿瘤作用。CM 和天然药物有多种类型，具有多种靶点、途径和广泛的药理作用。因此，它们已成为全球肿瘤学家的一个重要研究领域。大量研究表明，CM 和天然药物可以直接或间接增强先天免疫系统成分（包括巨噬细胞、自然杀伤细胞和髓样抑制细胞）、适应性免疫系统成分（如 T 淋巴细胞和调节性 T 细胞）、相关细胞因子（如 IL-2、IL-4、IL-10、TNF-α）和 PD-1/PD-L1 轴调节，从而增强免疫细胞对肿瘤细胞的细胞毒性。
这最终导致改善肿瘤免疫微环境，从而提高抗肿瘤疗效。本文批判性地研究了 CM 和天然药物在调节 GC 免疫治疗中的作用，旨在为 CM 领域的胃癌临床治疗和预防建立新的理论框架。
