结直肠癌PD-1/PD-L1阻断治疗的耐药研究现状

doi:10.3877/cma.j.issn.2095-3224.2021.02.015

PD-1/PD-L1阻断治疗是一种新的肿瘤治疗策略，在过去的十年中，PD-1/PD-L1阻断治疗在很多的恶性肿瘤中应用，取得了一定成功。而对于结直肠癌，只有DNA错配修复蛋白缺失（dMMR）微卫星高度不稳定（MSI-H）患者对PD-1/PD-L1的阻断治疗有积极的反应。原发性和获得性耐药，最终可能导致患者的疾病进展。因此，PD-1/PD-L1阻断治疗的耐药仍是阻碍其进一步应用的重大挑战。为克服阻断治疗的耐药性，人们进行了大量基于耐药机制的研究。在这篇综述里，我们概述了PD-1/PD-L1阻断治疗的现状并对其耐药机制进行探讨。对逆转其耐药的方法进行了讨论和展望，希望对提高PD-1/PD-L1阻断治疗疗效有所裨益。

关键词: 结直肠肿瘤, 程序性死亡受体-1, 免疫抑制治疗, 耐药机制

PD-1/PD-L1 blocking therapy is a new strategy for cancer treatment. In the past decade, PD-1/PD-L1 blocking therapy has been applied in a wide range of malignant tumors and achieved certain success. However, for colorectal cancer, only patients with deficiency mismatch repair (dMMR) and microsatellite instability high (MSI-H) have a positive response to PD-1/PD-L1 blocking therapy. Primary or acquired drug resistance may eventually lead to disease progression. Therefore, the resistance of PD-1/PD-L1 blocking therapy is still a major challenge hindering its further application. In order to overcome the resistance of blocking therapy, a large number of studies based on drug resistance mechanism have been carried out. In this review, we summarize the current status of PD-1/PD-L1 blocking therapy and explore the mechanism of drug resistance. The methods to reverse the drug resistance were prospected, hoping to improve the efficacy of PD-1/PD-L1 blocking therapy.

Key words: Colorectal neoplasms, Programmed death-ligand 1, Immunosupression therapy, Cancer immunotherapy resistance

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Research status of resistance to PD-1/PD-L1 blockade colorectal cancer immunotherapy

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Research status of resistance to PD-1/PD-L1 blockade colorectal cancer immunotherapy