Immunosurveillance in clinical cancer management

IF 503.1 1区 医学 Q1 ONCOLOGY CA: A Cancer Journal for Clinicians Pub Date : 2023-10-25 DOI:10.3322/caac.21818
Guido Kroemer MD, PhD, Timothy A. Chan MD, PhD, Alexander M. M. Eggermont MD, PhD, Lorenzo Galluzzi PhD
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Abstract

The progression of cancer involves a critical step in which malignant cells escape from control by the immune system. Antineoplastic agents are particularly efficient when they succeed in restoring such control (immunosurveillance) or at least establish an equilibrium state that slows down disease progression. This is true not only for immunotherapies, such as immune checkpoint inhibitors (ICIs), but also for conventional chemotherapy, targeted anticancer agents, and radiation therapy. Thus, therapeutics that stress and kill cancer cells while provoking a tumor-targeting immune response, referred to as immunogenic cell death, are particularly useful in combination with ICIs. Modern oncology regimens are increasingly using such combinations, which are referred to as chemoimmunotherapy, as well as combinations of multiple ICIs. However, the latter are generally associated with severe side effects compared with single-agent ICIs. Of note, the success of these combinatorial strategies against locally advanced or metastatic cancers is now spurring successful attempts to move them past the postoperative (adjuvant) setting to the preoperative (neoadjuvant) setting, even for patients with operable cancers. Here, the authors critically discuss the importance of immunosurveillance in modern clinical cancer management.

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癌症临床管理中的免疫监测。
癌症的进展涉及恶性细胞脱离免疫系统控制的关键步骤。当抗肿瘤药物成功恢复这种控制(免疫监测)或至少建立减缓疾病进展的平衡状态时,它们是特别有效的。这不仅适用于免疫疗法,如免疫检查点抑制剂(ICIs),也适用于常规化疗、靶向抗癌药物和放射治疗。因此,应激并杀死癌症细胞同时激发肿瘤靶向免疫反应(称为免疫原性细胞死亡)的疗法与ICI结合特别有用。现代肿瘤学治疗方案越来越多地使用这种组合,称为化学免疫疗法,以及多种ICI的组合。然而,与单剂ICI相比,后者通常会产生严重的副作用。值得注意的是,这些针对局部晚期或转移性癌症的组合策略的成功,现在正促使人们成功地尝试将其从术后(辅助)环境转移到术前(新辅助)环境,即使对于患有可手术癌症的患者也是如此。在这里,作者批判性地讨论了免疫监测在现代癌症临床管理中的重要性。
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来源期刊
CiteScore
873.20
自引率
0.10%
发文量
51
审稿时长
1 months
期刊介绍: CA: A Cancer Journal for Clinicians" has been published by the American Cancer Society since 1950, making it one of the oldest peer-reviewed journals in oncology. It maintains the highest impact factor among all ISI-ranked journals. The journal effectively reaches a broad and diverse audience of health professionals, offering a unique platform to disseminate information on cancer prevention, early detection, various treatment modalities, palliative care, advocacy matters, quality-of-life topics, and more. As the premier journal of the American Cancer Society, it publishes mission-driven content that significantly influences patient care.
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