进展期大肠癌免疫疗法的研究进展.docVIP

进展期大肠癌免疫疗法的研究进展 　　摘 要 目前，进展期大肠癌治疗缺乏有效手段，亟待研发新的治疗技术。近年来，免疫疗法已在血液系统肿瘤和黑素瘤的治疗中显示有显著疗效，且有多项免疫治疗技术试用于大肠癌治疗，包括肿瘤治疗性疫苗、免疫检查点抑制剂和过继细胞疗法等。其中，免疫检查点抑制剂抗程序性细胞死亡受体-1抗体已在DNA错配修复缺陷型大肠癌的治疗中显示有很好的疗效，但在血液系统肿瘤治疗中显示有显著疗效的嵌合抗原受体修饰的T细胞疗法却在大肠癌等实体瘤治疗中显示疗效欠佳，有一系列的问题需予解决。不过，免疫疗法已成为继手术、放疗和化疗后的第四大肿瘤疗法，将为进展期大肠癌治疗带来新的希望。 　　关键词 大肠癌 免疫疗法 研究进展 　　中图分类号：R735.34； R730.51 文献标识码：A 文章编号：1006-1533（2016）23-0003-04 　　The update of immunotherapy in advanced colorectal cancer 　　ZHU Jie， ZHENG Wanwei， CHEN Jian*， LUO Zhongguang* 　　（Department of Gastroenterology， Huashan Hospital， Fudan University， Shanghai 200040， China） 　　ABSTRACT At present， there is no effective strategy in the treatment of advanced colorectal cancer and the development of new treatment techniques is urgently needed. Immunotherapy has been currently shown to have a significant therapeutic effect in the treatment of hematological malignancies and melanoma and a number of immunotherapy technologies such as tumor vaccines， immune checkpoint inhibitors and adoptive cell therapies have been trialed in the treatment of colorectal cancer， especially the immune checkpoint inhibitors programmed cell death receptor-1 antibody that has shown an extraordinary effect in DNA mismatch repair-deficient colorectal cancer. Chimeric antigen receptor-expressing T cells therapy， one of the adoptive cell therapies， has already achieved breakthrough in non-solid tumors， but it has poor response to the colorectal cancers with a series of problems to be resolved. Anyway， immunotherapy has become the fourth promising tumor therapy after surgery， radiotherapy and chemotherapy， which would bring in hope to patients with advanced colorectal cancer. 　　KEY WORDS colorectal cancer； immunotherapy； research progress 　　2015年，我国大肠癌新发病例数达37.63万例，因大肠癌死亡者数近19.10万例，给家庭和社会带来了极大负担[1]。手术根治未转移的早期大肠癌能够显著延长患者的生存期。遗憾的是，大量大肠癌患者被诊出时已至疾病进展期[2]。对进展期大肠癌患者，目前采用化疗或靶向治疗仅可使少数患者获益，亟待研发新的治疗手段。近年来，免疫疗法已在血液系统肿瘤和黑素瘤等治疗中显示有极佳的疗效，且有多项免疫治疗技术试用于大肠癌治疗，包括肿瘤治疗性疫苗、免疫检查点抑制剂和过继细胞疗法等。本文就这些免疫疗法在进展期