在皮肤癌治疗中,abscopal效应和免疫调节
William J Nahm1,2, Goranit Sakunchotpanit3,4, Vinod E Nambudiri3,5
1New York University Grossman School of Medicine, New York, NY, USA. william.nahm@nyulangone.org.
American journal of clinical dermatology
|April 3, 2025
概括
辐射疗法 (RT) 可以触发腹腔效应 (AbE),远处的免疫反应. 将RT与免疫检查点抑制剂结合起来,可能会在皮肤癌中增强AbE,从而提供新的治疗途径.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 皮肤病学 皮肤病学
背景情况:
- 放射治疗 (RT) 是癌症治疗的基石,诱导DNA损伤和免疫刺激.
- 在附近的细胞中,RT可以引起旁观者效应 (ByE),而在远处的细胞中,则会引起外观效应 (AbE).
- 虽然RT可以增强抗瘤免疫力,但它也可能创造一种免疫抑制的微环境.
研究的目的:
- 审查当前对皮肤癌中abscopal效应 (AbE) 的理解.
- 探索RT与免疫调节的结合,特别是免疫检查点抑制剂 (ICI).
- 讨论在晚期皮肤恶性瘤中利用AbEs的机制,证据,挑战和未来方向.
主要方法:
- 文献综述,重点关注皮肤癌症中的腹膜效应 (AbE).
- 对结合放射治疗 (RT) 与免疫检查点抑制剂 (ICI) 的临床前和临床研究的分析.
- 探索诱导类似腹膜反应的替代方法.
主要成果:
- 在晚期皮肤癌如黑色素瘤和默克尔细胞癌中观察到abscopal效应 (AbE).
- 将RT与ICI (CTLA-4,PD-1/PD-L1抑制剂) 结合起来,显示出增强AbE发生率的潜力.
- 有证据表明,RT-ICI组合可以放大抗瘤免疫反应.
结论:
- 将RT与ICI结合起来,有望在治疗晚期皮肤癌时增强腹腔效应 (AbE).
- 需要进一步的研究来优化治疗组合,时间和患者选择,以实现一致的AbE诱导.
- 利用ABE可以在治疗转移性和晚期皮肤恶性瘤方面取得重大进展.
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