摘要
背景:肾细胞癌的治疗和免疫治疗正在迅速发展,主要包括免疫检查点抑制剂,是转移患者的治疗方案的革命性。新的放射治疗分割时间表,包括高剂量的小部分,可以克服该肿瘤的放射抵抗。局部放射治疗与全身性效应有关,即所谓的戒酒效应。放疗与免疫治疗结合可增强免疫系统介导的这种作用。 目的:在这篇综述中,我们探讨了放射治疗和免疫治疗在肾细胞癌中的作用,结合这些策略的基本原理,以及正在进行的研究这两种治疗模式组合的临床试验。 结论:免疫治疗和放射治疗的结合具有很强的理论基础和临床前研究的支持,因为它可以克服肿瘤微环境的免疫抑制,增加抗肿瘤免疫反应。需要从临床试验中获得更多的临床证据,以证明这些治疗联合使用的有效性和安全性。
关键词: 肾细胞癌,放射治疗,免疫治疗,异位效应,免疫检查点抑制剂,PD-1/PD-L1抑制剂
图形摘要
[http://dx.doi.org/10.3322/caac.21551 ] [PMID: 30620402]
[http://dx.doi.org/10.1016/j.eururo.2016.02.029 ] [PMID: 26935559]
[http://dx.doi.org/10.1016/j.critrevonc.2019.07.020 ] [PMID: 31401421]
[http://dx.doi.org/10.1016/j.celrep.2018.06.032 ] [PMID: 29925010]
[http://dx.doi.org/10.1056/NEJMra1601333 ] [PMID: 28121507]
[http://dx.doi.org/10.1007/s40261-019-00773-w ] [PMID: 30937824]
[http://dx.doi.org/10.1016/j.clgc.2016.09.004 ] [PMID: 27789182]
[http://dx.doi.org/10.1056/NEJMoa1510665 ] [PMID: 26406148]
[http://dx.doi.org/10.1056/NEJMoa1712126 ] [PMID: 29562145]
[http://dx.doi.org/10.1016/S1470-2045(19)30413-9 ] [PMID: 31427204]
[http://dx.doi.org/10.1056/NEJMoa1816714 ] [PMID: 30779529]
[http://dx.doi.org/10.1056/NEJMoa1816047 ] [PMID: 30779531]
[http://dx.doi.org/10.1038/nature21349 ] [PMID: 28102259]
[http://dx.doi.org/10.1038/nature12477 ] [PMID: 23945592]
[http://dx.doi.org/10.1038/s41588-018-0312-8 ] [PMID: 30643254]
[http://dx.doi.org/10.1038/s41591-018-0053-3 ] [PMID: 29867230]
[http://dx.doi.org/10.1016/S1470-2045(13)70569-2 ] [PMID: 24694640]
[http://dx.doi.org/10.1093/annonc/mdz056 ] [PMID: 30788497/]
[http://dx.doi.org/10.1084/jem.180.2.525 ] [PMID: 8046331]
[http://dx.doi.org/10.1186/1748-717X-6-34 ] [PMID: 21477295]
[http://dx.doi.org/10.1126/science.1082504 ] [PMID: 12750523]
[http://dx.doi.org/10.1016/S1043-6618(03)00052-5 ] [PMID: 12676513]
[http://dx.doi.org/10.1186/1475-2867-10-40 ] [PMID: 12676513]
[http://dx.doi.org/10.1038/sj.onc.1206702 ] [PMID: 20974006]
[http://dx.doi.org/10.1016/j.ccr.2005.07.014 ] [PMID: 12947396]
[http://dx.doi.org/10.1016/0360-3016(87)90283-5 ] [PMID: 3553111]
[http://dx.doi.org/10.1016/j.radonc.2005.03.022 ] [PMID: 15972239]
[http://dx.doi.org/10.1097/01.coc.0000145289.57705.07 ] [PMID: 15577450]
[http://dx.doi.org/10.1080/02841860802123196 ] [PMID: 18607859]
[http://dx.doi.org/10.1016/j.ijrobp.2008.01.043 ] [PMID: 18374507]
[http://dx.doi.org/10.1111/j.1464-410X.2012.11550.x ] [PMID: 23107102]
[http://dx.doi.org/10.1002/cncr.31156 ] [PMID: 29266183]
[http://dx.doi.org/10.1007/s00066-010-2055-z ] [PMID: 20165820]
[http://dx.doi.org/10.1016/S0360-3016(00)00804-X ] [PMID: 11121638]
[http://dx.doi.org/10.1016/S0140-6736(04)16250-8 ] [PMID: 15158627]
[http://dx.doi.org/10.1200/JCO.2010.30.1655 ] [PMID: 21041710]
[http://dx.doi.org/10.1093/neuros/nyy146 ] [PMID: 29771381]
[http://dx.doi.org/10.1016/j.ijrobp.2011.02.040 ] [PMID: 21596489]
[http://dx.doi.org/10.1016/j.prro.2012.01.005 ] [PMID: 24674192]
[http://dx.doi.org/10.1016/j.canlet.2013.09.018 ] [PMID: 24125863]
[http://dx.doi.org/10.1016/S1470-2045(09)70082-8 ] [PMID: 19573801]
[http://dx.doi.org/10.1259/0007-1285-26-305-234 ] [PMID: 13042090]
[http://dx.doi.org/10.1016/j.currproblcancer.2015.10.001]
[http://dx.doi.org/10.1080/02841860600604611 ] [PMID: 16760190]
[http://dx.doi.org/10.1007/s12609-017-0234-y ] [PMID: 28344743]
[http://dx.doi.org/10.1056/NEJMoa1112824 ] [PMID: 22397654]
[http://dx.doi.org/10.1136/gut.43.4.575 ] [PMID: 9824589]
[http://dx.doi.org/10.1016/j.currproblcancer.2015.10.003 ] [PMID: 26612692]
[http://dx.doi.org/10.4049/jimmunol.1200563 ] [PMID: 22685313]
[http://dx.doi.org/10.1186/s13045-018-0647-8 ] [PMID: 30115069]
[http://dx.doi.org/10.1038/nrc3958 ] [PMID: 26105538]
[http://dx.doi.org/10.1038/bjc.1997.119 ] [PMID: 9043022]
[http://dx.doi.org/10.1667/RR1931.1 ] [PMID: 20334512]
[http://dx.doi.org/10.1074/jbc.M802967200 ] [PMID: 18544535]
[http://dx.doi.org/10.1038/nrc3380 ] [PMID: 23151605]
[http://dx.doi.org/10.1038/nm1622 ] [PMID: 17704786]
[http://dx.doi.org/10.3389/fonc.2014.00325 ] [PMID: 25506582]
[http://dx.doi.org/10.1158/0008-5472.CAN-10-2820 ] [PMID: 21300764]
[http://dx.doi.org/10.1084/jem.20101159 ] [PMID: 21930765]
[http://dx.doi.org/10.4049/jimmunol.180.5.3132 ] [PMID: 18292536]
[http://dx.doi.org/10.1158/0008-5472.CAN-14-3511 ] [PMID: 25858148]
[http://dx.doi.org/10.1158/1078-0432.CCR-07-1157 ] [PMID: 17875754]
[http://dx.doi.org/10.1158/1078-0432.CCR-11-0544 ] [PMID: 22028490]
[http://dx.doi.org/10.4049/jimmunol.174.12.7516 ] [PMID: 15944250]
[http://dx.doi.org/10.1016/j.ijrobp.2010.09.034 ] [PMID: 21093169]
[http://dx.doi.org/10.3389/fimmu.2014.00489 ] [PMID: 25339957]
[http://dx.doi.org/10.1016/j.ijrobp.2003.09.012 ] [PMID: 14967443]
[PMID: 10626784]
[PMID: 12702593]
[http://dx.doi.org/10.1038/nrc.2018.6 ] [PMID: 29449659]
[http://dx.doi.org/10.1182/blood-2009-02-206870 ] [PMID: 19349616]
[http://dx.doi.org/10.1002/cncr.29889 ] [PMID: 26914620]
[http://dx.doi.org/10.1097/COC.0b013e3182868ec8 ] [PMID: 25616204]
[PMID: 15701862]
[http://dx.doi.org/10.3892/ijo.31.3.509 ] [PMID: 17671676]
[http://dx.doi.org/10.1158/1078-0432.CCR-09-0265 ] [PMID: 19706802]
[http://dx.doi.org/10.1002/1097-0215(20011215)94:6<825::AID-IJC1545>3.0.CO;2-5 ] [PMID: 11745485]
[http://dx.doi.org/10.1002/ijc.20036 ] [PMID: 14999775]
[http://dx.doi.org/10.1371/journal.pone.0171559 ] [PMID: 28222111]
[http://dx.doi.org/10.1158/1078-0432.CCR-14-2824 ] [PMID: 25869387]
[http://dx.doi.org/10.1158/0008-5472.CAN-14-1258 ] [PMID: 25274032]
[http://dx.doi.org/10.1016/0360-3016(83)90261-4 ] [PMID: 6885543]
[http://dx.doi.org/10.1155/2011/439752 ] [PMID: 22162711]
[http://dx.doi.org/10.1371/journal.pone.0157164 ] [PMID: 27281029]
[http://dx.doi.org/10.1186/s40425-016-0156-7 ] [PMID: 27660705]
[http://dx.doi.org/10.1007/s12026-012-8349-8 ] [PMID: 22961658]
[http://dx.doi.org/10.1158/0008-5472.CAN-10-1439 ] [PMID: 20841473]
[http://dx.doi.org/10.1126/science.1202947 ] [PMID: 21474713]
[http://dx.doi.org/10.1016/S1470-2045(15)00007-8 ] [PMID: 26433823]
[http://dx.doi.org/10.1158/2326-6066.CIR-14-0196 ] [PMID: 25527358]
[http://dx.doi.org/10.1158/2326-6066.CIR-14-0138 ] [PMID: 25701325]
[http://dx.doi.org/10.1016/j.ctrv.2018.07.010 ] [PMID: 30096699]
[PMID: 23390376]
[http://dx.doi.org/10.1158/1078-0432.CCR-10-2232 ] [PMID: 21467163]
[http://dx.doi.org/10.1073/pnas.1016791108 ] [PMID: 21173239]
[http://dx.doi.org/10.4161/onci.28780 ] [PMID: 25083318]
[http://dx.doi.org/10.1080/15384047.2016.1264543 ] [PMID: 27905824]
[http://dx.doi.org/10.1172/JCI67313 ] [PMID: 24382348]
[http://dx.doi.org/10.1016/j.canlet.2015.05.012 ] [PMID: 25980820]
[http://dx.doi.org/10.1016/j.euo.2019.05.007 ] [PMID: 31302061]
[http://dx.doi.org/10.1080/21645515.2015.1049779]