晚期胃癌免疫治疗新进展

晚期胃癌免疫治疗新进展摘要：晚期胃癌预后差，病死率高，化疗、放疗等传统治疗手段以及靶向治疗均效果欠佳。免疫治疗是当前癌症治疗领域的新生力量，目前常用的治疗策略包括免疫检查点调节以及继性细胞治疗、肿瘤疫苗等。多项临床试验证实免疫检查点调节对于晚期胃癌治疗具有极大潜在价值，目前研究的药物 Ipilimumab、Tremelimumab、Pembrolizumab、Nivolumab 等能够阻断免疫检查点的抑制，增强免疫系统的抗肿瘤活性，对治疗晚期胃癌均有一定疗效。尤其是PD-Ll 高表达的晚期胃癌患者更可能接受抗 PD-L1 治疗而获益。免疫治疗可能导致某些不良反应，但经过适当治疗，大部分不良反应症状可在 2～4 周转归。化疗、放疗等治疗手段导致患者免疫功能受损，是晚期胃癌免疫治疗必须面对的重大挑战。本文对晚期胃癌免疫治疗的主要策略、临床研究、药物开发等方面的最新进展作出综述，并分析其面临挑战与发展前景。关键词：胃癌；晚期；免疫治疗；New progress in immunotherapy of advanced gastric cancerAbstract:Advanced gastric cancer has poor prognosis and high mortality, the traditional therapeutic methods such as chemotherapy and radiotherapy and targeted therapy are not effective.Immunotherapy is a new force in the field of cancer treatment.At present, the commonly used treatment strategies include immune checkpoint regulation and follow-up cell therapy for tumor vaccine.A number of clinical trials have confirmed that immune checkpoint regulation has great potential value in the treatment of advanced gastric cancer. Currently, Ipilimumab Tremelimumab Pembrolizumab Nivolumab and other drugs studied can block the inhibition of immune checkpoints, enhance the anti-tumor activity of the immune system, and have certain efficacy in the treatment of advanced gastric cancer. In particular, patients with advanced gastric cancer with high expression of PD-Ll are more likely to benefit from anti-PD-Ll treatment. Immunotherapy may lead to some adverse reactions, but with appropriate treatment, most o...