放疗与免疫检查点抑制剂联合治疗肿瘤的研究进展

Progression of radiotherapy combined with immune checkpoint inhibitors for the treatment of tumor

  • 摘要: 放疗主要是通过诱导DNA损伤直接杀死肿瘤细胞,还可通过激活宿主免疫成分间接作用于肿瘤组织,从而诱导抗肿瘤免疫反应,但在某些情况下也能导致免疫抑制。近年来,免疫检查点抑制剂的发展在多种肿瘤中显示出巨大的治疗潜力,其中又以程序性死亡受体1(PD-1)和程序性死亡配体1(PD-L1)抑制剂最具代表性,但其在一些免疫“冷”肿瘤中并不起作用。基于放疗与免疫检查点抑制剂在肿瘤组织中的作用机制,研究人员发现PD-1/PD-L1抑制剂可以解除放疗导致的免疫抑制,而放疗可以使免疫“冷”肿瘤转换为免疫“热”肿瘤从而受益于免疫治疗,因此,二者的联合应用引起了研究人员的广泛关注。笔者将主要介绍放疗与PD-1/PD-L1抑制剂联合应用的作用机制,总结其最新的研究进展,这对临床选择合适的获益人群、评估疗效与预后具有重要意义。

     

    Abstract: Radiation therapy mainly kills tumor cells directly by inducing fatal DNA damage, and can also act on tumor tissues indirectly by activating host immune components, thereby inducing anti-tumor immune responses, but on the other hand, it can also lead to some immunosuppression. In recent years, the development of immune checkpoint inhibitors has shown a great therapeutic potential, especially the programmed cell death receptor-1 (PD-1) and programmed cell death ligand-1 (PD-L1) inhibitors, while it can't work in immune "cold" tumors. Based on the mechanism of action of radiotherapy and immune checkpoint inhibitors in tumor tissue, it was found that PD-1/PD-L1 inhibitors can relieve the immunosuppression induced by radiotherapy, allowing immuno "cold" tumors to be transformed into immuno "hot" tumors and thus benefit from immunotherapy. So, the combination of them has attracted extensive attention . In here, the author mainly introduces the mechanism of radiation therapy combined with PD-1/PD-L1 inhibitors and new progress was summarized, which is of great significant in selecting the right beneficiaries and estimating curative effect and prognosis.

     

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