Ochoa A C, Longo D L
Division of Cancer Treatment, National Cancer Institute, Frederick, Maryland, USA.
Important Adv Oncol. 1995:43-54.
The progressive growth of tumor induces a major alteration in the immune response which could have significant deleterious consequences on the outcome of immunotherapeutic strategies. A more complete understanding of the mechanisms involved and the clinical consequences of these alterations is necessary to determine the importance of such changes. It is possible however, that the analysis of the TCR sigma chain or other signal transduction elements can be a more informative way to monitor the therapeutic effects of a particular treatment than the functional immunologic assays on peripheral blood lymphocytes used presently. Ultimately understanding this phenomenon could help determine the treatment approaches that would prevent or reverse the state of altered immune response, allowing for the development of more effective cancer treatments. It is clear that there are a number of barriers to successful immunotherapy (Table 4-1). Each difficulty has a number of potential solutions. It seem likely that as each of these known barriers is overcome, a larger number of patients will benefit than do now from the current generation of treatment approaches. Of course, it is also likely that there are additional barriers to success yet to be uncovered. It is only through careful observation and monitoring of the clinical effects of our interventions that the remaining obstacles will be defined. And it is only through the close interaction of the laboratory and the clinic that novel solutions will be devised.
肿瘤的渐进性生长会引起免疫反应的重大改变，这可能对免疫治疗策略的结果产生严重的有害影响。更全面地了解这些改变所涉及的机制及其临床后果，对于确定这些变化的重要性至关重要。然而，分析TCR σ链或其他信号转导元件，可能比目前对外周血淋巴细胞进行的功能性免疫测定，是一种更具信息性的监测特定治疗效果的方法。最终，了解这一现象有助于确定能够预防或逆转免疫反应改变状态的治疗方法，从而开发出更有效的癌症治疗方法。显然，成功的免疫治疗存在许多障碍（表4-1）。每个难题都有许多潜在的解决方案。似乎随着这些已知障碍的逐一克服，将有比目前更多的患者从当前一代治疗方法中受益。当然，也有可能存在尚未被发现的其他成功障碍。只有通过仔细观察和监测我们干预措施的临床效果，才能确定剩下的障碍。只有通过实验室与临床的密切互动，才能设计出新的解决方案。
