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鼻咽癌的免疫治疗

2018年11月17日

编译：肿瘤资讯

来源：肿瘤资讯

鼻咽癌的免疫治疗

Edwin P Huii

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

免疫疗法早在19世纪便由William B. Coley教授发现，在沉寂了上百年后，科学家们发现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的这次报告将展示鼻咽癌免疫疗法的过去、现在及将来，包括过继性EBV特异性T细胞疗法、EBV疫苗、免疫检查点抑制剂、联合用药及免疫指标等内容。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。其次，多个临床试验证实免疫检查点抑制剂在鼻咽癌中具有良好的应用前景。未来，联合用药有望进一步提高肿瘤患者的生存，如抗血管生成治疗联合免疫治疗药物可将肿瘤微环境从免疫抑制改造为免疫支持从而发挥协同作用。此外，一些免疫指标（如PD-L1, TMB, MSI-H）有利于进一步提高癌症患者的生存。

Immunotherapy in Nasopharyngeal Carcinoma

Past, Present and the Future

Immunotherapy was discovered by Dr. William b. Coley as early as the 19th century. After a century, scientists have discovered that immunity plays an increasingly important role in cancer treatment. 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 about past, present and future of immunotherapy in Nasopharyngeal Carcinoma. 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. Next, several clinical trials of immune check point inhibition have reported promising result in Nasopharyngeal Carcinoma. In the future, combination immune-oncology is expected to further improve the survival of tumor patients. For example, antiangiogenic treatment reprograms the tumor microenvironment from immunosuppressive to immunosupportive, so it can increase the efficacy of immunotherapy. Besides, immune biomarkers (such as PD-L1, TMB, MSI-H) are hopeful to further improve the overall survival of cancer patients.

2020年08月10日

李玉洋

莱州市人民医院 | 肿瘤内科

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，从而识别出肿瘤细胞。

2020年07月17日

刘祥东

湛江市第一中医院 | 肿瘤科

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