优化癌症免疫疗法的非药物干预。

IF 7.2 2区 医学 Oncoimmunology Pub Date : 2023-09-28 eCollection Date: 2023-01-01 DOI:10.1080/2162402X.2023.2255459
Maximilian Boesch, Florent Baty, Frank Rassouli, Tobias Kowatsch, Markus Joerger, Martin Früh, Martin H Brutsche
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引用次数: 1

摘要

癌症患者作为需要最大限度休息和保护的虚弱个体的传统形象开始消失。过于关注医疗方面以及自身的脆弱性和死亡率可能会适得其反,也不会公正对待人性的复杂性。与细胞毒性和淋巴消耗治疗不同,免疫参与治疗可以增强免疫系统,通常对患者的危害较小。因此,接受检查点抑制剂的癌症患者本身并不被视为易受感染,至少在免疫学和物理方面不被视为。这篇观点文章主张采用一种全面的方法来治疗癌症免疫疗法,以一名有能力的患者为中心,关注个人资源,并从医疗保健专业人员那里获得特定领域的支持。它总结了非药物干预的最新证据,以增强免疫检查点阻断的疗效并提高生活质量。这些干预措施针对的是行为因素,如饮食、体力活动、压力管理、检查点抑制剂输注的昼夜节律,以及放弃不必要的联合用药,从而降低免疫疗法的疗效。非药物干预措施具有普遍可及性、广泛适用性、即时可操作性、可扩展性和经济可持续性,为所有相关利益攸关方创造价值。最重要的是,这个整体框架重新强调了患者的整体性,并充分利用了抗癌免疫和检查点阻断的潜力,有可能带来生存益处。数字疗法被提议陪伴患者完成改变生活方式相关行为的使命,为治疗效果和个人成长创造最佳条件。
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Non-pharmaceutical interventions to optimize cancer immunotherapy.

The traditional picture of cancer patients as weak individuals requiring maximum rest and protection is beginning to dissolve. Too much focus on the medical side and one's own vulnerability and mortality might be counterproductive and not doing justice to the complexity of human nature. Unlike cytotoxic and lympho-depleting treatments, immune-engaging therapies strengthen the immune system and are typically less harmful for patients. Thus, cancer patients receiving checkpoint inhibitors are not viewed as being vulnerable per se, at least not in immunological and physical terms. This perspective article advocates a holistic approach to cancer immunotherapy, with an empowered patient in the center, focusing on personal resources and receiving domain-specific support from healthcare professionals. It summarizes recent evidence on non-pharmaceutical interventions to enhance the efficacy of immune checkpoint blockade and improve quality of life. These interventions target behavioral factors such as diet, physical activity, stress management, circadian timing of checkpoint inhibitor infusion, and waiving unnecessary co-medication curtailing immunotherapy efficacy. Non-pharmaceutical interventions are universally accessible, broadly applicable, instantly actionable, scalable, and economically sustainable, creating value for all stakeholders involved. Most importantly, this holistic framework re-emphasizes the patient as a whole and harnesses the full potential of anticancer immunity and checkpoint blockade, potentially leading to survival benefits. Digital therapeutics are proposed to accompany the patients on their mission toward change in lifestyle-related behaviors for creating optimal conditions for treatment efficacy and personal growth.

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来源期刊
Oncoimmunology
Oncoimmunology ONCOLOGY-IMMUNOLOGY
CiteScore
12.80
自引率
2.80%
发文量
276
期刊介绍: Tumor immunology explores the natural and therapy-induced recognition of cancers, along with the complex interplay between oncogenesis, inflammation, and immunosurveillance. In response to recent advancements, a new journal, OncoImmunology, is being launched to specifically address tumor immunology. The field has seen significant progress with the clinical demonstration and FDA approval of anticancer immunotherapies. There's also growing evidence suggesting that many current chemotherapeutic agents rely on immune effectors for their efficacy. While oncologists have historically utilized chemotherapeutic and radiotherapeutic regimens successfully, they may have unwittingly leveraged the immune system's ability to recognize tumor-specific antigens and control cancer growth. Consequently, immunological biomarkers are increasingly crucial for cancer prognosis and predicting chemotherapy efficacy. There's strong support for combining conventional anticancer therapies with immunotherapies. OncoImmunology will welcome high-profile submissions spanning fundamental, translational, and clinical aspects of tumor immunology, including solid and hematological cancers, inflammation, and both innate and acquired immune responses.
期刊最新文献
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