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免疫治疗在神经母细胞瘤治疗中的作用

英文原题:The role of immunotherapy in the treatment of neuroblastoma.

PubMed 2026/05/22(内容时间) Surg Today Q2 · IF 2.3(JCR 2025)

研究概要

神经母细胞瘤是儿童最常见的颅外实体瘤。

中文摘要

神经母细胞瘤是儿童最常见的颅外实体瘤。尽管采用化疗、手术切除、放疗和自体干细胞移植等多模式治疗,高危疾病的预后仍然较差。免疫治疗显著改善了治疗结局,尤其是抗GD2单克隆抗体,目前已成为标准维持治疗。细胞因子联合异维A酸方案提高了生存率,化学免疫治疗在复发/难治性情况下也显示出更高的缓解率。人源化或Fc工程化等新一代抗体旨在降低毒性并提高疗效。GD2疫苗和细胞疗法,包括CAR-T细胞、NK/NKT细胞疗法以及双特异性抗体介导的T细胞疗法,均显示出良好活性,尤其是在微小残留病灶方面。然而,GD2下调、免疫抑制性肿瘤微环境以及制造方面的限制仍然存在。未来策略可能包括整合抗体、疫苗和细胞平台的多模式免疫治疗,并结合精准患者选择和微环境调节。免疫治疗正在重塑神经母细胞瘤治疗格局,有望实现更深度缓解和长期疾病控制。

展开英文摘要原文

Neuroblastoma is the most common extracranial solid tumor in children. The prognosis for high-risk disease remains poor despite multimodal therapy, including chemotherapy, surgical resection, radiotherapy, and autologous stem-cell transplantation. Immunotherapy has improved outcomes remarkably, particularly using anti-GD2 monoclonal antibodies, which are now established as standard maintenance therapy. Combination regimens of cytokines and isotretinoin have enhanced survival, and chemo-immunotherapy has demonstrated superior response rates in relapsed/refractory settings. The aim of treatment with next-generation antibodies, such as humanized or Fc-engineered formats, is to reduce toxicity and improve efficacy. GD2-based vaccines and cellular therapies, including CAR-T cells, NK/NKT cell therapy, and bispecific antibody-armed T cells, have shown promising activity, particularly for minimal residual disease. However, challenges such as GD2 downregulation, an immunosuppressive tumor microenvironment, and manufacturing constraints persist. Future strategies may involve multimodal immunotherapy integrating antibodies, vaccines, and cellular platforms with precise patient selection and microenvironment modulation. Immunotherapy is reshaping neuroblastoma treatment, with the potential to achieve both deeper remission and long-term disease control.

论文信息

作者
Kawakubo N、Maniwa J、Yamaguchi Y、Ueda M、Hino Y、Kamouchi A、Ishimoto K、Fukuhara M
单位
Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. kawakubo.naonori.061@m.kyushu-u.ac.jp.Japan
文献类型
综述
期刊
Surgery today2026 Sep
原文标识
PubMed 42171699 · DOI 10.1007/s00595-026-03327-8