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甲状腺癌患者的免疫治疗:一项综合性评价

英文原题:Immunotherapy for patients with thyroid cancer: a comprehensive appraisal.

PubMed 2024/05/21(内容时间) Chin Clin Oncol Q3 · IF 2.7(JCR 2025)

研究概要

甲状腺癌是最常见的内分泌恶性肿瘤。

中文摘要

甲状腺癌是最常见的内分泌恶性肿瘤。尽管治疗取得了进展,它仍然构成重大挑战。免疫治疗利用人体免疫系统来对抗癌症,已成为一种潜在的解决方案。免疫系统与癌细胞的相互作用遵循一个复杂的过程,涉及免疫监视、平衡和逃逸。另一方面,癌细胞发展出多种机制,如抗原性和免疫原性丧失,以及创建免疫抑制的肿瘤微环境,以逃避免疫反应。免疫治疗模式,包括免疫检查点抑制剂如抗细胞毒性T淋巴细胞相关蛋白4(CTLA-4)和抗程序性细胞死亡蛋白1/程序性细胞死亡蛋白配体1(PD-1/PD-L1),已在多种癌症中显示出有希望的结果。在甲状腺癌方面,免疫治疗,特别是PD-1/PD-L1阻断,已在滤泡细胞来源的甲状腺癌和甲状腺髓样癌(MTCs)患者中进行探索。使用PD-1/PD-L1抑制剂(如pembrolizumab和nivolumab)的临床试验已针对这些病例开展,并取得了不同程度的成功。尽管临床前研究表明免疫治疗模式对滤泡细胞来源的甲状腺癌患者具有潜在益处,但迄今为止,临床研究未能证明对晚期甲状腺癌患者有明确的临床获益。此外,其他方法如树突状细胞疫苗和放射免疫治疗主要针对MTC进行了探索,显示出潜力但需要进一步研究。尽管免疫治疗前景广阔,特别是在与其他治疗联合应用时,但仍需进一步的研究和高质量的临床试验来确定其在治疗晚期甲状腺癌中的有效性。

展开英文摘要原文

Thyroid cancer is the most common endocrine malignancy. It presents a significant challenge despite advances in treatment. Immunotherapy, which harnesses the body's immune system to fight cancer, has emerged as a potential solution. The immune system's interaction with cancer cells follows a complex process involving immune surveillance, equilibrium, and escape. On the other hand, cancer cells develop mechanisms, such as loss of antigenicity and immunogenicity, as well as creating an immunosuppressed tumor microenvironment, to evade immune response. Immunotherapy modalities, including immune checkpoint inhibitors like anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and anti-programmed cell death protein 1/programmed cell death protein-ligand 1 (PD-1/PD-L1), have shown promising results in various cancers. In the context of thyroid cancer, immunotherapy, particularly PD-1/PD-L1 blockade, has been explored in patients with follicular cell-derived thyroid carcinomas and medullary thyroid carcinomas (MTCs). Clinical trials using PD-1/PD-L1 inhibitors, such as pembrolizumab and nivolumab, have been conducted for these cases, with varying degrees of success. Although preclinical studies have suggested the potential benefit of immunotherapy modalities for patients with follicular cell-derived thyroid carcinoma, to date, clinical studies have failed to demonstrate clear clinical benefits in patients with advanced thyroid cancer. Additionally, other approaches like dendritic cell vaccination and radioimmunotherapy have been explored mainly for MTC, showing potential but requiring further investigation. While immunotherapy holds promise, especially in combination with other treatments, further research, and high-quality clinical trials are necessary to establish its effectiveness in treating advanced thyroid cancers.

论文信息

作者
Pinheiro Neto A、Lucchesi HL、Valsecchi VADS、Ward LS、Cunha LL
单位
Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil; Division of Emergency Medicine and Evidence-based Medicine, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.Brazil
文献类型
综述
期刊
Chinese clinical oncology2024 Jun
原文标识
PubMed 38859604 · DOI 10.21037/cco-23-133