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免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)主要是通过减少肿瘤细胞对机体免疫系统的抑制作用来提高免疫细胞的活化、肿瘤抗原识别、转运、浸润和杀伤能力,进而增强体内的抗肿瘤免疫反应来发挥其抗肿瘤作用[1-2]。不同于传统的肿瘤治疗方法(如手术、放疗和化疗等)直接杀灭肿瘤细胞而使肿瘤的体积缩小或代谢减慢,ICIs在治疗过程中会引起肿瘤浸润淋巴细胞增多,进而导致假性进展、超进展、延迟反应和肿瘤耀斑等特殊的反应模式[3-5]。因此,现行的恶性肿瘤疗效评价标准不完全适用于评价ICIs的治疗效果。为此,研究者对免疫治疗相关的恶性肿瘤疗效评价标准进行了修订,我们就此进行综述。
免疫治疗相关的恶性肿瘤疗效评价标准纵览
Overview of the immunotherapy-related response evaluation criteria in malignant tumors
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摘要: 免疫检查点抑制剂(ICIs)作为一种新型治疗药物,极大地丰富了癌症的治疗手段,但随之出现的免疫相关反应模式(如假性进展、延迟反应和超进展等)对现行的恶性肿瘤疗效评价标准提出了挑战。因此,研究者对相关的评价标准进行了一些修订,使其能够更客观准确地评价ICIs的治疗效果,以便更科学地指导临床治疗方案的制定。笔者就近年来提出的免疫治疗相关的恶性肿瘤疗效评价标准进行综述。Abstract: As a new type of therapeutic drug, immune checkpoint inhibitors (ICIs) has greatly enriched the cancer therapies. However, the subsequent emergence of immune-related response patterns, such as pseudoprogression, delayed response and hyperprogression have challenged the current response evaluation criteria in malignant tumors. Therefore, researchers have constantly revised the relevant evaluation criteria to enable them to assess the therapeutic effects more objectively and guide the formulation of clinical therapy more scientifically. This paper reviews the immunotherapy-related response evaluation criteria in malignant tumors proposed in recent years.
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