Li Yibo, Deng Jingui, Liu Yayong, Yu Shuangfeng
Department of Scientific Research, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Department of Obstetrics and Gynecology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Front Immunol. 2025 Jul 30;16:1645019. doi: 10.3389/fimmu.2025.1645019. eCollection 2025.
Cervical cancer remains a leading cause of cancer-related mortality in women, particularly in low-resource settings, despite advances in treatment modalities. The tumor immune microenvironment (TME) plays a pivotal role in cervical cancer pathogenesis, progression, and therapeutic response, driven largely by persistent HPV infection and subsequent immune evasion mechanisms. Clinical evidence supports the efficacy of pembrolizumab in PD-L1-positive recurrent/metastatic disease, while combinatorial strategies show promise in overcoming resistance. However, challenges persist, including biomarker identification and management of immune-related adverse events. This review elucidates the dynamic interplay between HPV-mediated immune suppression and the TME, highlighting the roles of tumor-associated macrophages (TAMs), regulatory T cells (Tregs), myeloid-derived suppressor cells (MDSCs), and exhausted lymphocyte subsets in fostering an immunosuppressive milieu. Overall, this review integrates current advances in tumor immunology and immunotherapy, providing a comprehensive framework for developing precision-based strategies to improve outcomes in cervical cancer.
尽管治疗方式有所进步,但宫颈癌仍是女性癌症相关死亡的主要原因,尤其是在资源匮乏地区。肿瘤免疫微环境(TME)在宫颈癌的发病机制、进展和治疗反应中起着关键作用,这在很大程度上是由持续性人乳头瘤病毒(HPV)感染及随后的免疫逃逸机制所驱动的。临床证据支持帕博利珠单抗在PD-L1阳性复发/转移性疾病中的疗效,而联合策略在克服耐药性方面显示出前景。然而,挑战依然存在,包括生物标志物的识别以及免疫相关不良事件的管理。本综述阐明了HPV介导的免疫抑制与TME之间的动态相互作用,强调了肿瘤相关巨噬细胞(TAM)、调节性T细胞(Treg)、髓源性抑制细胞(MDSC)和耗竭淋巴细胞亚群在营造免疫抑制环境中的作用。总体而言,本综述整合了肿瘤免疫学和免疫治疗的当前进展,为制定基于精准医学的策略以改善宫颈癌治疗结果提供了一个全面的框架。
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