癌症免疫治療新進展

治療癌症的方法日新月異，包含：手術切除、放射治療、化學治療、標靶治療等，對於癌症的治療已經可以有效延長病人的壽命，但是事實上，因為癌細胞具有很高的變異性，現今的治療方法並不能有效根治癌症，且容易衍生出癌症抗藥性的問題。而最新的免疫療法，則為癌症治療帶來新曙光。免疫治療的主要精髓，就是重新喚醒病患的免疫系統，讓體內原有的免疫功能重新活化，去攻擊體內的癌細胞。目前已針對PD-L1與CTLA-4研發單株抗體藥物能夠藉由阻斷PD-L1或CTLA-4與免疫細胞結合，讓免疫細胞能夠再度活化起來。而嵌合抗原受體T細胞療法（CAR-T），則是將裝配後的T細胞再輸入回患者體內，它們能夠辨別癌細胞，啟動免疫系統殺死癌細胞。癌症疫苗的研發，則試圖利用這些疫苗啟動免疫系統內具有特殊記憶的細胞以攻擊體內癌細胞。不過，目前僅有少部分的患者可透過免疫療法得到醫治。因此如何透過適當的生物標記找到合適接受治療的患者，是目前醫界最重要的課題。新的免疫治療法雖然帶來新希望，但免疫療法也有可能造成一些自體免疫疾病等副作用需要留意。隨著對癌症免疫學的更多認識，免疫治療已在臨床醫學上得到突破性的進步，期望在不久的將來，能結合各種不同有效的治療策略，更有效控制癌症。

關鍵字

癌症免疫療法；免疫檢查點阻斷劑；細胞療法；癌症疫苗

並列摘要

Cancer remains a leading cause of mortality worldwide. Advance has been made in treating cancer including surgery, radiotherapy, chemotherapy, and target therapy. However, a significant proportion of patients still die despite treatment, indicating that new, more effective managements for cancer therapy are needed. Cancer immunotherapy is providing a revolutionizing cancer treatment through enhancing the body’s antitumor immune functions. Immune checkpoint blockade with monoclonal antibodies directed at the inhibitory immune receptors CTLA-4, PD-1, and PD-L1 has emerged as a successful treatment for cancer patients. In addition, a range of cancer immunotherapy approaches have proven effective in many patients, including: monoclonal antibodies, immune checkpoint blockers, cancer vaccines, and cell-based therapies. The success observed with cancer immunotherapy treatments emphasizes the importance of understanding tumor immunology, particularly the roles of tumor antigens and the immunosuppressive tumor microenvironment. Many novel immunotherapy agents have been developed that effectively fight cancer. Nevertheless, immunotherapy can cause side effects as skin reactions or flu-like symptoms. Though the most common adverse effects are mild, immunotherapies may also cause severe or even fatal allergic reactions. Fortunately, many new immunotherapy strategies and agents are being researched and tested in clinical trials, which will hopefully provide new effective treatments for patients living with relapsed or refractory malignancies.