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近年来,肿瘤免疫治疗取得重大突破性进展,以CAR-T为代表的细胞免疫治疗在血液肿瘤的治疗中取得了令人鼓舞的临床疗效,免疫卡控点抑制剂CTLA-4和PD-1/PD-L1单抗也相继获批用于临床。然而,大多数实体肿瘤患者并不能从免疫治疗中获益。本文从个体化新抗原表位的筛选、免疫细胞活力的维持、免疫细胞趋化与浸润、临床治疗模式和评价标准等方面总结了实体肿瘤免疫治疗难以见效的关键问题,并且从临床应用角度阐述其应对策略。
In recent years, significant progress has been made in tumor immunotherapy. Cellular immune therapy represented by CAR-T has achieved encouraging clinical effects in the treatment of hematological tumors. The immunoprecipitation inhibitor CTLA-4 and PD-1 / PD-L1 monoclonal antibody have also been approved for clinical use. However, most solid tumor patients do not benefit from immunotherapy. This article summarizes the key problems that the solid tumor immunotherapy is hard to be effective in the aspects of the screening of the individual new antigen epitopes, the maintenance of immune cell vitality, the chemotaxis and infiltration of immune cells, the clinical treatment mode and the evaluation criteria, and the clinical application Its coping strategy