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免疫治疗在鼻咽癌中的应用

2018年01月19日

编译：肿瘤资讯

来源：肿瘤资讯

Edwin P Hui

i教授

威尔士亲王医院临床肿瘤科
香港中文大学
香港医学专科学院院士

正如英国著名剧作家乔治.萧伯纳所言“刺激吞噬细胞乃治疗万病之根本”，免疫在肿瘤治疗中发挥着越来越重要的角色。以鼻咽癌为例，EB病毒在鼻咽癌细胞中持续存在，因此可以利用T细胞免疫系统通过识别病毒表达的抗原（如EBNA1、LMP1、LMP2等），从而识别出肿瘤细胞。Dr. Edwin的这次报告将展示目前在临床上进行的免疫疗法相关研究，包括过继性EBV特异性T细胞疗法、EBV疫苗以及免疫检查点抑制剂。首先介绍过继性EBV特异性疗法，它可绕开抗原提呈途径，直接激活自体细胞毒性T淋巴细胞，从而直接杀死肿瘤细胞。该项研究正在进行3期临床试验。其次，通过接种EBV疫苗（如将EBNA-1和LMP2嵌合基因插入改良安卡拉痘病毒构建而成），可提高接种者免疫系统识别肿瘤抗原能力。此外，几个正在进行的临床试验证实免疫检查点抑制剂具有良好的应用前景。未来，联合免疫及肿瘤学，无疑会进一步提高癌症患者的生存。

英文原文

The Emerging Role Of Immunotherapy In
Nasopharyngeal Carcinoma (NPC)

Edwin P Hui

Department of Clinical Oncology, Prince of Wales Hospital

The Chinese University of Hong Kong

As the saying by George Bernard Shaw goes “There is at bottom only one genuinely scientific treatment for all diseases, and that is to stimulate the phagocytes”, immunotherapy has since occupied a position in treating cancer. Take nasopharyngeal carcinoma (NPC) as an example, the consistent presence of Epstein Barr Virus (EBV) in the tumor cells opens up the possibility of an immunotherapeutic approach, exploiting the potential of the immune T-cell system to recognize tumor cells through their expression of viral antigens (EBNA1, LMP1 and LMP2). This presentation will provide an overview on the approaches that are being investigated in the clinic. The first approach is adoptive EBV-specific T-cell therapy, which directly activates autologous cytotoxic T lymphocyte (CTL) to kill cancer cells. This approach is being tested in an ongoing phase 3 clinical trial. A second approach is therapeutic EBV vaccines, for example by inserting EBNA1-LMP2 chimeric gene into Modified Vaccinia Ankara in the MVA-EL vaccine. Therapeutic EBV vaccine has demonstrated improved tumor antigen recognition by the host immune system. Finally, several ongoing clinical trials of immune check point inhibition have reported promising result. In the future, combination immune-oncology is posted to improve the overall survival of cancer patients.