肿瘤细胞治疗研究
英文原题：Current immunotherapeutic approaches to diffuse intrinsic pontine glioma.
弥漫内生型脑桥胶质瘤（DIPG）是一种侵袭性脑肿瘤，发生于脑干脑桥，占所有脑干胶质瘤的 80% 以上。
弥漫性内生型脑桥胶质瘤（DIPG）是一种侵袭性脑肿瘤，发生于脑干脑桥，占脑干胶质瘤的 80% 以上。诊断中位年龄为 6–7 岁，诊断后 2 年总生存率低于 10%，5 年生存率低于 1%。DIPG 无法通过手术触及，放疗仅带来短暂获益，患者最终因肿瘤持续局部浸润而死亡。DIPG 目前是儿童脑肿瘤死亡的首要原因，其社会癌症负担以损失寿命年（YLL）计每名患者超过 67 年，而肺癌和乳腺癌分别约为 14 年和 16 年。针对儿童 DIPG 已开展 95 项以上临床药物试验，但均未能改善生存。迄今尚无单药或联合化疗策略取得成功，原因在于难以为该疾病确定靶向药物，也难以使药物穿过完整的血脑屏障（BBB）。因此，DIPG 免疫治疗研究受到越来越多关注，探索的疗法包括CAR-T（CAR-T）细胞、免疫检查点阻断、癌症疫苗及自体细胞转移疗法。本综述回顾了影响 DIPG 免疫治疗发展的遗传因素最新进展，并探讨磁共振引导聚焦超声（MRgFUS）等新兴技术在联合治疗中的潜在应用。
Diffuse intrinsic pontine glioma (DIPG) is an aggressive brain tumour that occurs in the pons of the brainstem and accounts for over 80% of all brainstem gliomas. The median age at diagnosis is 6-7 years old, with less than 10% overall survival 2 years after diagnosis and less than 1% after 5 years. DIPGs are surgically inaccessible, and radiation therapy provides only transient benefit, with death ensuing from relentless local tumour infiltration. DIPGs are now the leading cause of brain tumour deaths in children, with a societal cancer burden in years of life lost (YLL) of more than 67 per individual, versus approximately 14 and 16 YLL for lung and breast cancer respectively. More than 95 clinical drug trials have been conducted on children with DIPGs, and all have failed to improve survival. No single or combination chemotherapeutic strategy has been successful to date because of our inability to identify targeted drugs for this disease and to deliver these drugs across an intact blood-brain barrier (BBB). Accordingly, there has been an increased focus on immunotherapy research in DIPG, with explorations into treatments such as chimeric antigen receptor T (CAR-T) cells, immune checkpoint blockades, cancer vaccines, and autologous cell transfer therapy. Here, we review the most recent advances in identifying genetic factors influencing the development of immunotherapy for DIPG. Additionally, we explore emerging technologies such as Magnetic Resonance-guided Focused Ultrasound (MRgFUS) in potential combinatorial approaches to treat DIPG.
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