研究概要
肾母细胞瘤(WT)是儿童最常见的肾脏恶性肿瘤,占所有儿童肾癌的90%以上。
中文摘要
Wilms瘤(WT)是儿童最常见的肾脏恶性肿瘤,占所有儿童肾癌的90%以上。尽管该肿瘤通常对治疗有反应,但仍有相当比例的患者出现复发和死亡。WT中常见的基因改变及其独特的组织学特征和肿瘤微环境提示,免疫系统可能在该病的发生和进展中发挥关键作用。传统疗法(包括手术、化疗和放疗)在预防WT患者复发方面的局限性及其可能产生长期副作用,使得免疫治疗等新型治疗策略在该病中的应用成为必要。免疫治疗是一种新兴的癌症治疗方法,其理念是利用患者的免疫系统来对抗肿瘤细胞。由于其相对较高的特异性、疗效和耐受性,该方法已在多种类型的癌症中展现出令人鼓舞的结果。然而,免疫治疗在WT中的确切效果仍有待探索。为此,本综述重点阐述了不同免疫治疗方法(如单克隆抗体、过继性细胞治疗和免疫检查点抑制剂)在WT患者中的潜在应用,并特别关注该肿瘤的遗传学和组织学特征。尽管关于该病免疫治疗的最佳使用方式仍有许多待了解之处,但现有证据表明,免疫治疗有潜力显著改善WT患者的预后。然而,仍然迫切需要开展进一步研究,尤其是随机对照试验,以确定针对该肿瘤最有效的免疫治疗策略。此外,未来研究应探讨免疫治疗与传统治疗联合的潜在获益作用。
展开英文摘要原文
Wilms' tumor (WT) is the most common renal malignancy in children, accounting for more than 90% of all pediatric renal cancers. Although this tumor is generally responsive to treatment, relapses and deaths still occur in a significant proportion of patients. The genetic alterations commonly found in WT and also its unique histological features and the tumor microenvironment suggest that the immune system may play a crucial role in the disease's development and progression. The limitations of conventional therapies, including surgery, chemotherapy, and radiotherapy, in preventing recurrence in WT patients and their potential for exerting long-term side effects, necessitate the application of novel therapeutic strategies, like immunotherapy, in this disease. Immunotherapy is an emerging cancer treatment approach based on the concept of harnessing the patient's immune system to fight tumor cells. This approach has demonstrated promising results in various types of cancers due to its relatively high specificity, efficacy, and tolerability. However, the precise effects of immunotherapy in WT remain to be explored. For this purpose, this review highlights the potential implication of different immunotherapy approaches, like monoclonal antibodies, adoptive cell therapy, and immune checkpoint inhibitors, in patients with WT, with a particular emphasis on the tumor's genetic and histological features. Although much remains to be learned about the optimal use of immunotherapy for this disease, the available evidence suggests that immunotherapy has the potential to significantly improve outcomes for patients with WT. However, there is still a substantial need for conducting further studies, especially randomized controlled trials, to determine the most effective immunotherapy strategy for this tumor. Moreover, the potential beneficiary roles of the combination of immunotherapy and conventional treatments should be investigated in future research.
论文信息
- 作者
- Sanatkar SA、Heidari A、Arya S、Ghasemi M、Rezaei N
- 第一作者单位
- Department of Surgery, Massachusetts General Hospital, Boston, USA.United States
- 通讯作者单位
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.Iran
- 文献类型
- 综述
- 期刊
- Current pharmaceutical design2023