Tumor immunotherapy, as a major breakthrough in the medical field in recent years, is gradually changing the treatment mode of cancer. By restarting and maintaining the body's anti-tumor immune response, tumor immunotherapy provides patients with new treatment hope and survival opportunities. This article will comprehensively analyze the basic principles, classification, clinical applications, and future prospects of tumor immunotherapy, providing valuable references for the medical community and patients.

1、Basic principles of tumor immunotherapy

Under normal circumstances, the human immune system is able to recognize and eliminate abnormal cells in the body, including tumor cells. However, tumor cells can evade the surveillance and clearance of the immune system through a series of complex mechanisms, such as immune escape, allowing them to survive and continue to proliferate. Immune escape is one of the important mechanisms in the occurrence and development of tumors, and it is also a core issue that needs to be addressed in tumor immunotherapy.

In order to better understand the complexity of tumor immunity, researchers have proposed the concept of tumor immune cycle. This cycle includes seven key steps: tumor antigen release, tumor antigen presentation, initiation and activation of effector T cells, migration of T cells to tumor tissue, T cell infiltration into tumor tissue, T cell recognition of tumor cells, and clearance of tumor cells. Any abnormality in any link may lead to the failure of anti-tumor immune circulation, resulting in immune escape.

2、Classification of tumor immunotherapy

1. Immune checkpoint inhibitors based on monoclonal antibodies: Immune checkpoint inhibitors are currently one of the most representative drugs in tumor immunotherapy. They restore T cell activity by blocking immune checkpoints such as PD-1/PD-L1 and CTLA-4, thereby enhancing the immune system's killing ability against tumor cells.

2. Therapeutic antibodies: Therapeutic antibodies refer to antibody drugs that specifically bind to tumor cell surface antigens, thereby blocking tumor cell growth, metastasis, or inducing apoptosis. These drugs have shown good efficacy and safety in tumor treatment and have become an important component of tumor immunotherapy.

3. Cancer vaccine: Cancer vaccine is a treatment method that stimulates the body's own immune system to recognize and kill tumor cells. Vaccines usually contain tumor specific antigens or tumor associated antigens, which can be injected to stimulate the body to produce specific anti-tumor immune responses. Currently, multiple cancer vaccines are undergoing clinical trials and showing promising application prospects.

4. Cell therapy: Cell therapy refers to a treatment method that uses the patient's own immune cells or genetically modified immune cells to attack tumor cells. Among them, CAR-T cell therapy is one of the most representative cell therapy methods. By using genetic engineering technology, CAR (chimeric antigen receptor) genes that specifically recognize tumor cells are introduced into T cells, enabling T cells to specifically recognize and kill tumor cells. At present, CAR-T cell therapy has achieved significant therapeutic effects in treating various blood tumors.

5. Small molecule inhibitors: Small molecule inhibitors refer to drugs that exert anti-tumor effects by inhibiting the activation of specific signaling pathways within tumor cells or blocking key molecules required for tumor cell growth. These drugs have the advantages of small molecular weight, easy synthesis and modification, and easy penetration of cell membranes, and play an important role in tumor treatment.

3、Clinical application of tumor immunotherapy

1. Melanoma: Melanoma is one of the earliest cancer types to achieve breakthroughs in tumor immunotherapy. PD-1/PD-L1 inhibitors and CTLA-4 inhibitors have shown excellent efficacy in the treatment of melanoma. For melanoma patients who cannot undergo surgical resection or metastasis, PD-1 inhibitors can be used as first-line treatment regardless of the presence of BRAF mutations.

2. Non small cell lung cancer: Non small cell lung cancer (NSCLC) is the most common type of cancer, accounting for approximately 85% of cancer cases. With the deepening of research, immune checkpoint inhibitors have also made significant progress in the treatment of non-small cell lung cancer. For patients with advanced or metastatic non-small cell lung cancer, especially those with positive PD-L1 expression or high tumor mutation burden, PD-1/PD-L1 inhibitors have become an important treatment option. These inhibitors can significantly improve the overall survival (OS) and progression free survival (PFS) of patients, with better safety and quality of life compared to chemotherapy.

3. Renal cell carcinoma: Renal cell carcinoma (RCC) is a malignant tumor originating from the renal tubular epithelium and is insensitive to radiotherapy and chemotherapy. The emergence of immune checkpoint inhibitors has brought new hope for the treatment of renal cell carcinoma patients. Multiple clinical trials have shown that PD-1/PD-L1 inhibitors have shown good efficacy in the treatment of renal cell carcinoma, especially in first-line or second-line treatment, which can significantly prolong the survival of patients. In addition, the combined use of immune checkpoint inhibitors and tyrosine kinase inhibitors (TKIs), such as sunitinib or axitinib, has also shown better therapeutic effects than monotherapy.

4. Other tumor types: In addition to the above tumor types, immune checkpoint inhibitors have shown potential in treating various other tumors, such as head and neck squamous cell carcinoma, gastric cancer, cancer, hepatocellular carcinoma, etc. Although research in these fields is still in the exploratory stage, preliminary clinical data has shown the potential efficacy of immunotherapy for these tumors.

4、Challenges and Future Prospects of Tumor Immunotherapy

Despite significant progress in tumor immunotherapy in recent years, it still faces many challenges. Firstly, immunotherapy is not effective for all patients and there are significant individual and response differences. Secondly, immunotherapy may cause a series of immune related adverse reactions (irAE), such as skin reactions, enteritis, pneumonia, etc., which require close monitoring and management. In addition, the high cost of immunotherapy limits its application in some patients.

In order to overcome these challenges and further promote the development of tumor immunotherapy, future research will focus on the following aspects: the development of biomarkers. Through in-depth research on the tumor immune microenvironment and immune response mechanism, more biomarkers that can predict the efficacy and toxicity of immunotherapy will be discovered to achieve precision medicine; Combination therapy strategy, exploring the combined application of immunotherapy and other treatment methods (such as chemotherapy, radiotherapy, targeted therapy, etc.) to improve treatment efficacy and reduce adverse reactions; Research and development of new immunotherapy: continue to develop new immunotherapy, such as bispecific antibodies, CAR-NK cell therapy, TCR-T cell therapy, etc., expand the application scope of immunotherapy, and improve efficacy; The optimization of personalized immunotherapy involves developing personalized immunotherapy plans based on the patient's genotype, immune status, and tumor characteristics to achieve precise and personalized treatment.

Tumor immunotherapy, as a major breakthrough in the medical field in recent years, is gradually changing the treatment mode of cancer. By activating or restoring the body's own immune system to combat tumors, this treatment method can not only improve treatment efficacy, but also reduce the side effects of traditional chemotherapy and radiation therapy. With the emergence of the Beacon Optofluidic System from Redbert (Beijing) Biotechnology Co., Ltd., it saves you a lot of time and greatly reduces production costs. The Beacon Optofluidic System can intervene when the cell diversity and survival rate reach their optimum after transfection, and it is easy to screen multiple cells and select cell lines with higher expression levels, thereby greatly reducing subsequent production costs. We have reason to believe that tumor immunotherapy will play a more important role in the future, bringing hope and opportunities for recovery to more cancer patients.

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