临床药物对免疫检查点抑制剂抗肿瘤效果影响的研究进展

Research progress on influence of clinical drugs on antitumor effect of immune checkpoint inhibitors

  • 摘要: 尽管免疫检查点抑制剂(ICI)能够显著改善多种实体肿瘤晚期患者的临床预后,但仍有相当一部分患者并不能从ICI治疗中获益。在临床实践中,抗生素、糖皮质激素、质子泵抑制剂和β受体阻滞剂等多种药物能够通过不同机制影响ICI药物的抗肿瘤效果。抗生素及质子泵抑制剂可能通过影响肠道菌群抑制ICI的治疗效果,而β受体阻滞剂则可能通过抑制β肾上腺素受体信号通路增强肿瘤对ICI的治疗敏感性。糖皮质激素对ICI治疗效果的影响可能依赖于其适应证如肿瘤/非肿瘤相关症状及免疫治疗相关副反应。本研究对上述临床药物在ICI治疗中的相关研究进行综述,以期为优化晚期肿瘤患者ICI个体化治疗策略提供理论依据。

     

    Abstract: Although immune checkpoint inhibitors (ICI) can significantly improve the clinical prognosis of patients with advanced solid tumors, a considerable number of patients still can't benefit from ICI treatment. In clinical practice, lots of drugs such as antibiotics, glucocorticoids, proton pump inhibitors and β receptor blockers can affect the antitumor effect of ICI drugs through different mechanisms. Antibiotics and proton pump inhibitors may inhibit the therapeutic effect of ICI by affecting intestinal flora, and β receptor blockers may enhance tumor sensitivity to ICI therapy by inhibiting β adrenoceptor signaling pathway. The effect of glucocorticoid on the therapeutic effect of ICI may depend on its indications, such as tumor/non-tumor related symptoms and immunotherapy related side effects. This study reviewed the related researches on the above clinical drugs in ICI treatment, in order to provide a theoretical basis for optimizing the individualized treatment strategy of ICI in patients with advanced tumors.

     

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