In 2011, the Ipilimumab was approved for melanoma therapy, marking the beginning of the tumor immunotherapy revolution; in 2013, the tumor immunotherapy was selected as the top ten scientific and technological breakthroughs in “Science”;
In 2018, the Nobel Prize in Physiology or Medicine was awarded to American scientist James Aireson and Japanese scientist Ben Mo, in recognition of their contributions to “discovering negative immunode treatment of cancer therapy”.
What is the sacred development of tumor immunotherapy so fast?
On December 15th, “World Reinforcement Immune Day”, Professor Su Shicheng, the Breast Tumor Center of Sun Yixian Memorial Hospital of Sun Yat -sen University, takes you to unveil the mystery of tumor immunity and interpret the new dawn of this cancer patient.
1. Immunotherapy has been listed as tumor treatment technology?
Su Shicheng: Yes!Immunotherapy is another major tumor treatment technology after surgery, radiotherapy, chemotherapy, endocrine therapy and targeted therapy. It is different from the direct killing and killing cancer cells from traditional treatment such as surgery, chemotherapy, and radiotherapy.The immune system to kill cancer cells.
2. What is the principle of tumor immunotherapy?
Su Shicheng: The immune system is a line of defense to guard human health. Immune cells are “patrol soldiers”. Normal human body also generates a small amount of evil change cells during cell copying.When immunity decreases, the continuous evolution and disguise of surviving evil -changing cells will cause immune cells to be unable to recognize in time. Evil cells eventually develop into the tumor tissue visible to the naked eye, and cancer occurs.
The mechanism of the action of tumor immunotherapy is very simple. The main use of immunotherapy in breast cancer is mainly to check point inhibitors PD1/PD-L1 antibody as an example:
(1) T cells use detection equipment to identify cell identity: The human body has a “PD-L1 protection card”, and T cells carry “PD-1 detection equipment”.T cells are the elite troops in the immune system soldiers. The lethality is amazing. The first step in performing the task is to verify the identity, that is, T cells identify PD-L1 through the “PD-1 detection equipment”.Start attack on their own cells.Therefore, PD1/PD-L1 is also called “immune checkpoint”.
(2) Tumor cell camouflage: In the evolution, cunning tumor cells learned to disguise, and also carried the “PD-L1 protection card” with you, making T cell mistakenly think that it was its own cells and did not kill it.
(3) Block the detection equipment of T cells: The PD-1 antibody currently used in clinical applications is mainly acting on T cells, which is equivalent to blocking the detection equipment of T cells. The PD-L1 antibody confiscates the “PD-L1 of tumor cellsProtecting card “to expose his identity.
(4) T cells find tumor cells through other paths: T cells identify the cell identity of the cell through other paths, identify tumor cells in time and solve them early.
3. What is the effect of immunity treatment?
Su Shicheng: Compared with traditional therapy, there are three main advantages in immunotherapy: First, it can refer to immune memory. The “survival drag effect” is significant. Patients with effective immunotherapy have a great opportunity to survive high -quality long -term survival;The treatment of advanced cancer that has been extensively metastasized, especially for cancer patients who have failed all the standard therapy, can still achieve good results; third, immunotherapy is a broad -spectrum, which can treat a variety of different cancers and make different diseases with the same treatment.Reality.
4. Are all patients suitable for immunotherapy?
Su Shicheng: No!Immunotherapy needs to rely on the human body’s immune system to attack the tumor. Therefore, it is particularly important to evaluate the patient’s condition before use.This is why tumor immunotherapy is one of the fastest-developed tumor therapy, but only 20-30%of patients benefit!
5. Which are important evaluation indicators suitable for immunotherapy?
Su Shicheng: Tumor immunization is an important evaluation indicator.
Immune cells need to enter the tumor before they can identify and attack tumor cells. Therefore, tumor cells usually set up multiple levels to prevent immune cells from infiltrating.According to the degree of infiltration of the tumor of immune cells, tumors can now be divided into three immune phenomena: inflammatory types (inside the tumor), immune exclusion type (outside the tumor), and immune desert type (lack of immune cells).Among them, inflammatory tumors can produce effective immune response, which is the most sensitive to immune examination point inhibitors. Such patients often have better pre -pre -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -post -after -prognosis.
Of course, it is obviously not enough to rely on tumor immunization types to one indicator. Therefore, basic research and clinical research are committed to finding new indicators so that more tumor patients can apply immunotherapy.
6. Will it resist after receiving immunotherapy?
Su Shicheng: Like other treatments, tumor immunotherapy may also produce drug resistance!However, our team separated a CD16+fibroblast from the tumor specimen of breast cancer patients, and found that it played a key role in the hyperplasia of the tumor connective tissue, which hindered the incorrhizumab in the tumor tissue and the combination of the chemotherapy with chemotherapy.Drug delivery can reverse this resistance through targeting its action molecules!
In fact, how to overcome immunotherapy resistance has always been a major topic. Many basic research is striving to explore the method of cracking, and we are still working hard!
7. Is immunotherapy use for single medicine treatment?
Su Shicheng: Taking breast cancer as an example, the efficacy of breast cancer immunotherapy single drugs is limited. Whether it is early or advanced breast cancer, PD-1/PD-L1 immunoaged examination point inhibitors single drug treatment is low.At present, more joint treatment strategies are explored, such as immune+chemotherapy, immune+antemlodia generation therapy, and immune+targeted therapy.With the continuous improvement of diagnosis and treatment technology, breast cancer has become one of the best tumors, especially the blessing of immunotherapy in recent years, and the treatment effect has become more significant.Moreover, currently the existing immunotherapy is only the tip of the iceberg of potential immunotherapy strategies.One day, we can stop talking about cancer color changes, and immunotherapy may be the method of breaking the situation!
Su Shicheng, director and researcher of the Breast Oncology Center, is currently a member of the Party Committee and Assistant of the Party Committee and Dean of Sun Yixian Memorial Hospital of Sun Yat -sen University, deputy director of the Breast Oncology Center, Director of the Yixian Breast Mirror Center, Director of the Shuhua Breast Cancer Research Center, Director of Biological Therapy Technology CenterEssenceHe is also the vice chairman of the Guangdong Provincial Anti -Cancer Society; the youth executive director of the China Anti -Cancer Association; a member of the European Immunotherapy Association;Important awards such as youth science and technology innovation awards “and” seeking outstanding youth scholars awards “.Adhering to clinical orientation, internationally proposed a new view of “surgical reconstruction of plant anti -tumor immunity”, and created precision minimally invasive technologies such as navigation laparoscopic milk and other breast cancer.There are many breakthrough results in the study of the mechanism of immune micro -environment and the clinical application of immunotherapy, and propose a new plan for original immunotherapy with international influence.Prested by the National Nature Jieqing, major planning key projects, national key research and development plans, etc.; research results were selected as “Top Ten Progress of Chinese Universities in 2018”; 12 applications/obtained national invention patents; some achievements have been converted into new technologies or new technologies of tumor immunohians diagnosis or diagnosis diagnostic diagnosis orTransfer pharmaceutical companies to develop new drugs.Participated in the writing of China’s breast cancer guidelines for immunotherapy and obtained the “Top Ten Medical Innovation Experts in the country”.
(Edit: Ye Fang correspondent: Liu Wenqin, Weng Xiaoqi)