程序性死亡受体/配体免疫治疗策略在人乳头瘤病毒阳性头颈部鳞状细胞癌中的研究进展

Progress in research into programmed death-1/programmed death-ligand 1 immunotherapy strategies in human papillomavirus-positive head and neck squamous cell carcinoma

摘要

人乳头瘤病毒（HPV）感染已成为头颈部鳞状细胞癌（HNSCC）的主要致病因素之一，与HPV阴性相比，HPV阳性HNSCC表现出以程序性死亡受体（PD）为代表的多种免疫细胞及其效应分子的表达增加。PD-1/PD-L1高表达的患者与HPV阳性HNSCC患者存活率的显著提高相关。而HPV阳性HNSCC患者在接受抗PD-1/程序性死亡配体（PD-L1）免疫治疗后的客观缓解率、无进展生存期、总生存期等指标较HPV阴性HNSCC患者有所提高，提示HPV阳性HNSCC患者在接受抗PD-1/PD-L1免疫治疗上可能取得更好疗效。另外，PD-1/PD-L1抑制剂联合HPV癌症疫苗、双通路抑制剂等免疫治疗方案在HPV相关癌症中已发挥出独特的优势。根据HPV状态为患者制定个体化免疫治疗是一种有前景的治疗策略。

Abstract

Human papillomavirus (HPV) infection has become one of the main pathogenic factors of head and neck squamous cell carcinoma (HNSCC). The expression levels of various immune cells and effector molecules, including programmed death (PD)-1 and programmed death-ligand 1, are higher in HPV-positive HNSCC samples than in HPV-negative samples. Furthermore, patients with HPV-positive HNSCC and high PD-1 or PD-L1 expression showed significantly improved survival. Moreover, patients with HPV-positive HNSCC and on anti-PD-1/PD-L1 immunotherapy showed hi-gher objective remission rate (ORR), progression-free survival (PFS), overall survival (OS) and other indicators than patients with HPV-negative HNSCCs, suggesting that the former received greater clinical benefits than the latter. In addition, HPV cancer vaccine combined with PD-1/PD-L1 inhibitors, dual pathway inhibitors and other immunotherapy regimens play distinct beneficial roles in HPV-related cancer. Therefore, tailoring immunotherapy to patients based on HPV status is a promising treatment strategy.

关键词

头颈部鳞状细胞癌 / 人乳头瘤病毒 / 程序性死亡受体/配体 / 免疫治疗

Key words

head and neck squamous cell carcinoma / human papillomavirus / programmed death-1/programmed death-ligand 1 / immunotherapy

Author summay

刘世一，医师，硕士，Email：<email>[e-mail]</email>