文章摘要

放射治疗联合免疫疗法在癌症治疗中的研究进展

作者: 1白睿, 1袁程, 2龚䶮, 1谢丛华
1 武汉大学中南医院肿瘤放化疗科,武汉 430071
2 武汉大学中南医院生物样本库,武汉 430071
通讯: 谢丛华 Email: chxie_65@whu.edu.cn
DOI: 10.3978/j.issn.2095-6959.2019.04.033
基金: 国家自然科学基金 (81572967,81372498,81800429);国家重点临床专科建设项目 [No. (2013) 544];湖北省自然科学基金 (2013CFA006);武汉市黄鹤英才 (250000200);武汉大学中南医院科技创新培育基金 (znpy2016050,znpy2017001, znpy2017049);中央高校基本科研业务费专项资金资助 (2042018kf0065)。

摘要

放射治疗除具有杀伤肿瘤细胞的作用外,还具有有效的免疫刺激特性,有助于刺激免疫系统产生抗癌免疫反应。放射治疗可诱导恶性肿瘤细胞中的各种促免疫原性和表型的变化,并重新校准肿瘤微环境的免疫背景,导致先天免疫系统激活,并引发肿瘤特异性T细胞免疫。放射疗法的免疫依赖性为组合治疗策略的发展提供了合理的理论基础,由此可以利用放射的免疫调节性质来增强免疫治疗剂的活性。最近成功的突破性疗法如免疫检查点封闭,以及大量实验数据,均证明了放射疗法和免疫疗法组合的显著功效。目前,很多研究者正在进行大量实验对这种方法的临床潜力进行探索。放射治疗和免疫疗法的成功结合依赖于最合适的辐射剂量和分级,以及免疫疗法的选择。癌症的免疫控制现在正成为临床现实。人们相当乐观地认为,有效的放射治疗和免疫治疗结合能够诱导持久的全身免疫,这将进一步增强患者的治疗效果并改变癌症的未来管理。
关键词: 联合治疗;免疫检查点;免疫治疗;放射疗法

Research progress of radiotherapy combined with immunotherapy in cancer treatment

Authors: 1BAI Rui, 1YUAN Cheng, 2GONG Yan, 1XIE Conghua
1 Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
2 Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan 430071, China

CorrespondingAuthor: XIE Conghua Email: chxie_65@whu.edu.cn

DOI: 10.3978/j.issn.2095-6959.2019.04.033

Foundation: This work was supported by the National Natural Science Foundation (81572967, 81372498

Abstract

Besides its direct effects to kill tumor cells, radiotherapy was recognized to have potent immunostimulatory properties that contribute to the development of anti-cancer immune response. Radiotherapy was reported to induce various pro-immunogenic and phenotypic changes in malignant cells, and recalibrated the immune background of the tumor microenvironment, leading to activation of the innate immune system and triggering tumor-specific T cell immunity. The immune dependence of radiotherapy provides a rational for the development of combination therapy, whereby the immunomodulatory properties of radiation can be utilized to enhance the activity of immunotherapy. Recently successful strategies, such as immunological checkpoint blockade, and extensive experimental data demonstrated the efficacy of the combination of radiotherapy and immunotherapy. The clinical potential of this approach is currently being explored in a number of clinical trials. A successful combination requires careful consideration of the most appropriate radiation dose and fractionation, as well as immunotherapy options. The immune control of cancer is now becoming a clinical reality. It is quite optimistic that effective combination of radiotherapy and immunotherapy can induce long-term systemic immunity, which will further enhance the patient’s therapeutic effect and change the future management of cancer.
Keywords: combination therapy; immune checkpoint; immunotherapy; radiotherapy

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