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接受免疫治疗的癌症患者的临床结局与生活质量:范围综述

英文原题:Clinical Outcomes and Quality of Life in Cancer Patients Undergoing Immunotherapy: A Scoping Review.

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Clinical Outcomes and Quality of Life in Cancer Patients Undergoing Immunotherapy: A Scoping Review.

PubMed 2025/01/01(内容时间) Crit Rev Immunol Q4 · IF 1.8(JCR 2025)

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中文摘要

免疫治疗通过利用免疫系统靶向并摧毁癌细胞,改变了癌症治疗格局。本范围综述综合了关于关键免疫治疗药物临床结局和生活质量(QoL)影响的最新数据,包括检查点抑制剂(如 pembrolizumab、nivolumab)和 CAR-T 细胞疗法。在 PubMed 和 Google Scholar 中进行的系统检索确定了过去五年(2020-2024)发表的原创研究,聚焦于临床疗效和 QoL 指标。研究结果显示,免疫治疗带来了显著的生存获益和 QoL 改善,尤其是在血液系统恶性肿瘤中,CAR-T 细胞疗法在复发/难治性病例中表现出高效性。

然而,将这些获益扩展至实体瘤仍面临挑战,常见障碍为免疫相关毒性和可及性有限。有前景的新策略,如 CAR NK 细胞和联合方案,正在研究中,以提高安全性并扩大对实体瘤的适用性。影响结局的关键因素包括患者特异性因素,如基因突变、年龄以及临床试验人群构成的差异,这些因素同时影响疗效和 QoL。随着免疫治疗的进步,基于遗传和临床特征的个体化治疗方法对于优化结果将至关重要。

进一步研究应致力于降低毒性、拓宽靶点选择,并开发可及的现成疗法。本综述强调了免疫治疗对生存和 QoL 的影响,倡导在肿瘤学中推行精准医学,以改善以患者为中心的结局。

展开英文摘要原文

Immunotherapy has transformed cancer treatment by leveraging the immune system to target and destroy cancer cells. This scoping review synthesizes recent data on the clinical outcomes and quality of life (QoL) impacts of key immunotherapy agents, including checkpoint inhibitors (e. g. , pembrolizumab, nivolumab) and CAR T-cell therapies.

A systematic search in PubMed and Google Scholar identified primary studies published in the past five years (2020-2024) focusing on clinical efficacy and QoL metrics. Findings reveal that immunotherapy offers notable survival benefits and QoL improvements, especially in hematologic cancers, where CAR T-cell therapies demonstrate high efficacy in relapsed or refractory cases.

However, challenges remain in extending these benefits to solid tumors, with common obstacles being immune-related toxicities and limited access. Promising new strategies, such as CAR NK cells and combination regimens, are under investigation to enhance safety and applicability to solid tumors.

Critical factors influencing outcomes include patient-specific elements like genetic mutations, age, and variability in clinical trial demographics, which affect both efficacy and QoL. As immunotherapy advances, personalized treatment approaches informed by genetic and clinical profiles will be crucial for optimizing results.

Further research should address toxicity reduction, broaden target options, and develop accessible off-the-shelf therapies. This review underscores immunotherapy's impact on survival and QoL, advocating for precision medicine in oncology to enhance patient-centered outcomes.

论文信息

作者
Mahadev KAS、Yap YH、Tan SH
第一作者单位
Division of Applied Biomedical Sciences and Biotechnology, School of Health Sciences, IMU University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.Malaysia
通讯作者单位
Department of Biomedical Science, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia.Malaysia
文献类型
范围综述
期刊
Critical reviews in immunology2025
原文标识
PubMed 40743763 · DOI 10.1615/CritRevImmunol.2025057711