{"id":3627,"date":"2024-08-05T19:09:52","date_gmt":"2024-08-05T11:09:52","guid":{"rendered":"http:\/\/oncolab.cn\/index.php\/2024\/08\/05\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac33%e7%ab%a0-%e5%85%8d%e7%96%ab%e6%a3%80%e6%9f%a5%e7%82%b9%e6%8a%91%e5%88%b6%e5%89%82%e6%b2%bb%e7%96%97%e7%99%8c%e7%97%87%e7%9a%84%e5%89%af\/"},"modified":"2024-08-05T19:09:52","modified_gmt":"2024-08-05T11:09:52","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac33%e7%ab%a0-%e5%85%8d%e7%96%ab%e6%a3%80%e6%9f%a5%e7%82%b9%e6%8a%91%e5%88%b6%e5%89%82%e6%b2%bb%e7%96%97%e7%99%8c%e7%97%87%e7%9a%84%e5%89%af","status":"publish","type":"post","link":"http:\/\/oncolab.cn\/index.php\/2024\/08\/05\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac33%e7%ab%a0-%e5%85%8d%e7%96%ab%e6%a3%80%e6%9f%a5%e7%82%b9%e6%8a%91%e5%88%b6%e5%89%82%e6%b2%bb%e7%96%97%e7%99%8c%e7%97%87%e7%9a%84%e5%89%af\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c33\u7ae0 \u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6cbb\u7597\u764c\u75c7\u7684\u526f\u4f5c\u7528\uff08\u4e0a\uff09"},"content":{"rendered":"
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\u4e0a\u671f\u5185\u5bb9\uff1a\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c32\u7ae0\uff1a1\u671f\u8bd5\u9a8c\u4e2d\u7684\u514d\u75ab\u7597\u6cd5\uff08\u4e0b\uff09<\/span><\/a><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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33.1 \u7b80\u4ecb<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u662f\u4e00\u7c7b\u514d\u75ab\u8c03\u8282\u836f\u7269\uff0c\u5b83\u4eec\u901a\u8fc7\u5355\u514b\u9686\u6297\u4f53\u963b\u65ad\u80bf\u7624\u7ec6\u80de\u7528\u6765\u9003\u907f\u514d\u75ab\u7cfb\u7edf\u76d1\u89c6\u7684\u901a\u8def\u3002\u8fd9\u7c7b\u836f\u7269\u4e3b\u8981\u4f5c\u7528\u4e8eT\u7ec6\u80de\u8868\u9762\u7684\u67d0\u4e9b\u5173\u952e\u53d7\u4f53\uff0c\u5305\u62ec\u7ec6\u80de\u6bd2\u6027T\u6dcb\u5df4\u7ec6\u80de\u76f8\u5173\u86cb\u767d4\uff08CTLA-4\uff09\u548c\u7a0b\u5e8f\u6027\u6b7b\u4ea1\u86cb\u767d1\uff08PD-1\uff09\u53ca\u5176\u914d\u4f53PD-L1\u3002\u9996\u4e2a\u83b7\u6279\u7528\u4e8e\u764c\u75c7\u6cbb\u7597\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u662f\u6297CTLA-4\u7684\u4f0a\u5339\u5355\u6297\uff08ipilimumab\uff09\uff0c\u5176\u5728III\u671f\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u76f8\u6bd4\u6807\u51c6\u5316\u7597\u663e\u8457\u5ef6\u957f\u4e86\u60a3\u8005\u7684\u603b\u751f\u5b58\u671f\uff08OS\uff09\uff0c\u76ee\u524d\u5df2\u4f5c\u4e3a\u8f6c\u79fb\u6027\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u4e00\u7ebf\u6cbb\u7597\u836f\u7269\u3002\u7136\u800c\uff0c\u53e6\u4e00\u79cd\u6297CTLA-4\u6297\u4f53tremelimumab\u5728\u6cbb\u7597\u8f6c\u79fb\u6027\u9ed1\u8272\u7d20\u7624\u65f6\uff0c\u5e76\u672a\u663e\u793a\u51fa\u8d85\u8fc7\u6807\u51c6\u5316\u7597\u7684\u751f\u5b58\u4f18\u52bf\uff0c\u4f46\u5176\u5728\u5176\u4ed6\u80bf\u7624\u7c7b\u578b\u7684\u8054\u5408\u6cbb\u7597\u65b9\u6848\u4e2d\u6b63\u5904\u4e8e\u7814\u7a76\u9636\u6bb5\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u7b2c\u4e8c\u7c7b\u6291\u5236\u5242\u9488\u5bf9PD-1\u53ca\u5176\u914d\u4f53PD-L1\uff0c\u5df2\u5f00\u53d1\u51fa\u591a\u79cd\u6297\u4f53\u7528\u4e8e\u6cbb\u7597\u665a\u671f\u9ed1\u8272\u7d20\u7624\u4ee5\u53ca\u5305\u62ec\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u3001\u80be\u764c\u3001\u8180\u80f1\u764c\u3001\u5934\u9888\u764c\u548c\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u7b49\u591a\u79cd\u80bf\u7624\u3002\u5728\u8fd9\u65b9\u9762\uff0c\u7eb3\u6b66\u5229\u5c24\u5355\u6297\uff08nivolumab\uff09\u548c\u5e15\u535a\u5229\u73e0\u5355\u6297\uff08pembrolizumab\uff09\u4e3a\u76ee\u524d\u6700\u5148\u8fdb\u7684\u4e34\u5e8a\u5f00\u53d1\u836f\u7269\uff0c\u5df2\u83b7\u6279\u7528\u4e8e\u591a\u79cd\u9002\u5e94\u75c7\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u6297PD-L1\u836f\u7269\u65b9\u9762\uff0catezolizumab\u5df2\u88abFDA\u6279\u51c6\u7528\u4e8e\u6cbb\u7597\u8f6c\u79fb\u6027NSCLC\u548c\u665a\u671f\u5c3f\u8def\u4e0a\u76ae\u764c\uff0cavelumab\u7528\u4e8e\u6cbb\u7597\u8f6c\u79fb\u6027\u9ed8\u514b\u5c14\u7ec6\u80de\u764c\uff0c\u800cdurvalumab\u5219\u6b63\u5728\u5ba1\u6279\u8fc7\u7a0b\u4e2d\uff0c\u7528\u4e8e\u665a\u671f\u6216\u8f6c\u79fb\u6027\u5c3f\u8def\u4e0a\u76ae\u764c\u7684\u6cbb\u7597\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4f7f\u7528\u8fd9\u4e9b\u514d\u75ab\u8c03\u8282\u836f\u7269\u53ef\u80fd\u5bfc\u81f4\u4e00\u7cfb\u5217\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAEs\uff09\uff0c\u8fd9\u4e9b\u4e8b\u4ef6\u6e90\u4e8e\u514d\u75ab\u7cfb\u7edf\u7684\u8fc7\u5ea6\u6fc0\u6d3b\uff0c\u4ece\u800c\u51cf\u5f31\u4e86\u514d\u75ab\u53cd\u5e94\u7684\u6291\u5236(Fig <\/span>33.1<\/span>)\u3002\u8fd9\u4e9b\u4e0d\u826f\u53cd\u5e94\u5305\u62ec\u4e00\u4e9b\u4e3b\u8981\u7684\u75be\u75c5\u5982\u80c3\u80a0\u9053\u3001\u5185\u5206\u6ccc\u548c\u809d\u810f\u6bd2\u6027\u53cd\u5e94\uff0c\u53ca\u5176\u4ed6\u8f83\u5c11\u89c1\u7684\u708e\u75c7\u4e8b\u4ef6\u3002\u6240\u6709\u8fd9\u4e9b\u4e0d\u826f\u53cd\u5e94\u5177\u6709\u4e0d\u540c\u7684\u53d1\u75c5\u65f6\u95f4\uff0c\u9700\u901a\u8fc7\u4ed4\u7ec6\u76d1\u6d4b\u3001\u968f\u8bbf\u548c\u7ba1\u7406\u6765\u5904\u7406\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 33.1 \u53d7\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\u5f71\u54cd\u7684\u673a\u4f53\u7ec4\u7ec7<\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5982\u679c\u53ca\u65f6\u91c7\u53d6\u9002\u5f53\u7684\u5e72\u9884\u63aa\u65bd\uff0c\u8fd9\u4e9b\u4e0d\u826f\u4e8b\u4ef6\u901a\u5e38\u662f\u53ef\u9006\u7684\uff1b\u4f46\u5982\u672a\u80fd\u53ca\u65e9\u53d1\u73b0\u548c\u5904\u7406\uff0c\u53ef\u80fd\u4f1a\u4e25\u91cd\u5a01\u80c1\u751f\u547d\u3002\u9488\u5bf9ipilimumab\u76f8\u5173\u7684irAEs\uff0c\u7ba1\u7406\u6307\u5357\u5df2\u6839\u636e\u4e34\u5e8a\u7814\u7a76\u4e2d\u83b7\u5f97\u7684\u7ecf\u9a8c\u5236\u5b9a\uff0c\u5e76\u5f97\u5230FDA\u7684\u6279\u51c6\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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33.2 \u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\u53d1\u751f\u7387<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u63a5\u53d7\u4f0a\u5339\u5355\u6297\uff08ipilimumab\uff09\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\uff0c\u6700\u5e38\u89c1\u7684\u4e0d\u826f\u4e8b\u4ef6\u5305\u62ec\u8179\u6cfb\u3001\u7ed3\u80a0\u708e\u3001\u75b2\u52b3\u3001\u7619\u75d2\u3001\u76ae\u75b9\u548c\u5185\u5206\u6ccc\u5f02\u5e38\u3002\u5bf9\u4e8e\u4f7f\u7528PD-1\u6291\u5236\u5242\u7684\u60a3\u8005\uff0c\u5e38\u89c1\u7684\u4e0d\u826f\u4e8b\u4ef6\u5219\u5305\u62ec\u75b2\u52b3\u3001\u76ae\u75b9\u3001\u8179\u6cfb\u3001\u7619\u75d2\u3001\u5173\u8282\u75db\u548c\u4fbf\u79d8\u3002\u5728\u5355\u836f\u6cbb\u7597\u4e2d\uff0c\u4efb\u4f55\u7ea7\u522b\u7684\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAEs\uff09\u7684\u53d1\u751f\u7387\u4e3a15%\u81f390%\uff0c\u800c\u90a3\u4e9b\u4e25\u91cd\u5230\u9700\u8981\u514d\u75ab\u6291\u5236\u6cbb\u7597\u6216\u505c\u6b62\u514d\u75ab\u7597\u6cd5\u7684\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5176\u53d1\u751f\u7387\u4f30\u8ba1\u57280.5%\u523013%\u4e4b\u95f4\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5f53\u4f0a\u5339\u5355\u6297\u4e0ePD-1\u6291\u5236\u5242\u8054\u5408\u4f7f\u7528\u65f6\uff0c\u7ea654%\u7684\u60a3\u8005\u51fa\u73b0\u4e863\u81f34\u7ea7\u7684\u836f\u7269\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5176\u4e2d\u6700\u5e38\u89c1\u7684\u662f\u7ed3\u80a0\u708e\uff0817%\uff09\u3001\u8179\u6cfb\uff0811%\uff09\u548c\u8c37\u4e19\u8f6c\u6c28\u9176\u6c34\u5e73\u5347\u9ad8\uff0811%\uff09\u3002\u6cbb\u7597irAEs\u6240\u9700\u7684\u514d\u75ab\u6291\u5236\u836f\u7269\uff0c\u7279\u522b\u662f\u7528\u4e8e\u5904\u7406\u76ae\u80a4\u4e0d\u826f\u53cd\u5e94\u7684\u5916\u7528\u836f\u7269\uff0c\u5728\u8054\u5408\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u65f6\u7684\u4f7f\u7528\u7387\uff0889%\uff09\u8f83\u5355\u72ec\u4f7f\u7528\u65f6\uff0859%\uff09\u6709\u6240\u589e\u52a0\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u968f\u7740\u4f0a\u5339\u5355\u6297\u5242\u91cf\u4ece3 mg\/kg\u589e\u52a0\u523010 mg\/kg\uff0c\u4e0e\u4e25\u91cd\u4e0d\u826f\u4e8b\u4ef6\u7684\u98ce\u9669\u4e5f\u4ece7%\u589e\u52a0\u523025%\uff0c\u4e3b\u8981\u662f\u7531\u4e8e\u8179\u6cfb\u53d1\u4f5c\u6b21\u6570\u7684\u589e\u52a0\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u5c3c\u4f0f\u5355\u6297\uff08nivolumab\uff09\u7684\u5242\u91cf\u4ece0.3 mg\/kg\u589e\u52a0\u523010 mg\/kg\u65f6\uff0c\u5e76\u672a\u89c2\u5bdf\u5230\u7c7b\u4f3c\u7684\u6a21\u5f0f\u3002\u6d3e\u59c6\u5355\u6297\uff08pembrolizumab\uff09\u7684\u4e25\u91cd\u4e0d\u826f\u53cd\u5e94\u53d1\u751f\u7387\u5728\u4f7f\u75282 mg\/kg\u65f6\u4e3a20%\uff0c\u5728\u4f7f\u752810 mg\/kg\u65f6\u4e3a25%\uff0c\u672a\u968f\u5242\u91cf\u589e\u52a0\u800c\u663e\u8457\u589e\u52a0\u3002\u56e0\u6b64\uff0c\u4f0a\u5339\u5355\u6297\u7684\u6bd2\u6027\u4f3c\u4e4e\u4e0e\u5242\u91cf\u76f8\u5173\uff0c\u800cPD-1\/PD-L1\u6291\u5236\u5242\u7684\u6bd2\u6027\u5e76\u4e0d\u660e\u663e\u968f\u5242\u91cf\u589e\u52a0\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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33.3 \u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\u53d1\u751f\u65f6\u95f4<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4f0a\u5339\u5355\u6297\u6cbb\u7597\u5f15\u53d1\u7684\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAEs\uff09\u7684\u8d77\u59cb\u65f6\u95f4\u548c\u7ed3\u5c40\u56e0\u6240\u6d89\u53ca\u7684\u5668\u5b98\u800c\u5f02\u3002\u867d\u7136\u8fd9\u4e9b\u4e0d\u826f\u4e8b\u4ef6\u5927\u90e8\u5206\u5728\u6cbb\u7597\u7684\u524d\u4e09\u4e2a\u6708\u5185\u51fa\u73b0\uff0c\u4f46\u4e5f\u6709\u62a5\u544a\u663e\u793a\uff0c\u5373\u4fbf\u5728\u6cbb\u7597\u7ed3\u675f\u51e0\u4e2a\u6708\u540e\uff0c\u4ecd\u53ef\u51fa\u73b0\u4e00\u4e9b\u7279\u5b9a\u7684\u4e0d\u826f\u53cd\u5e94\u3002\u8fd9\u4e9b\u53cd\u5e94\u901a\u5e38\u662f\u6682\u65f6\u6027\u7684\uff0c\u4f8b\u5982\u76ae\u80a4\u75c7\u72b6\u901a\u5e38\u5728\u9996\u6b21\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u540e\u76842\u81f33\u5468\u5185\u9996\u5148\u51fa\u73b0\u3002<\/p>\n

\u514d\u75ab\u4ecb\u5bfc\u7684\u7ed3\u80a0\u708e\u548c\u809d\u708e\u7684\u53d1\u75c5\u65f6\u95f4\u4e5f\u6709\u6240\u4e0d\u540c\uff0c\u7ed3\u80a0\u708e\u4e00\u822c\u5728\u63a5\u53d7\u7b2c\u4e8c\u5242\u540e\u7ea65\u81f310\u5468\u51fa\u73b0\uff0c\u800c\u809d\u708e\u5219\u5728\u7b2c\u4e09\u5242\u540e\u768412\u81f316\u5468\u51fa\u73b0\u3002\u5185\u5206\u6ccc\u529f\u80fd\u969c\u788d\u5219\u53ef\u80fd\u4ece\u7b2c\u56db\u5242\u540e\u7684\u7b2c\u4e5d\u5468\u5f00\u59cb\u663e\u73b0\uff0c\u5e76\u4e14\u53ef\u80fd\u9700\u8981\u8f83\u957f\u65f6\u95f4\u624d\u80fd\u7f13\u89e3\uff0c\u6709\u65f6\u751a\u81f3\u53ef\u80fd\u662f\u6c38\u4e45\u6027\u7684\uff0c\u5982\u5927\u591a\u6570\u8111\u5782\u4f53\u708e\u75c7\u72b6\u4e00\u6837\u3002\u514d\u75ab\u4ecb\u5bfc\u7684\u80ba\u708e\u548c\u80be\u708e\u5219\u66f4\u665a\u51fa\u73b0\uff0c\u5206\u522b\u5728\u6cbb\u7597\u5f00\u59cb\u540e\u76848\u81f314\u5468\u548c14\u81f342\u5468\u88ab\u89c2\u5bdf\u5230\u3002\u8fd9\u4e9b\u4fe1\u606f\u5f3a\u8c03\u4e86\u5728\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u65f6\u5bf9\u60a3\u8005\u8fdb\u884c\u4ed4\u7ec6\u76d1\u6d4b\u548c\u53ca\u65f6\u7ba1\u7406\u7684\u91cd\u8981\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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33.4 \u4e00\u822c\u8003\u8651<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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FDA\u5df2\u6279\u51c6\u4e86\u9488\u5bf9\u4f0a\u5339\u5355\u6297\u76f8\u5173\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAEs\uff09\u7684\u7ba1\u7406\u6307\u5357\uff0c\u8fd9\u4e9b\u6307\u5357\u662f\u98ce\u9669\u8bc4\u4f30\u548c\u7f13\u89e3\u7b56\u7565\u7684\u91cd\u8981\u7ec4\u6210\u90e8\u5206\u3002\u4e0e\u4f0a\u5339\u5355\u6297\u76f8\u6bd4\uff0c\u6297PD-1\u6297\u4f53\uff0c\u7279\u522b\u662f\u5c3c\u4f0f\u5355\u6297\uff08nivolumab\uff09\u548c\u5e15\u535a\u5229\u73e0\u5355\u6297\uff08pembrolizumab\uff09\uff0c\u901a\u5e38\u5177\u6709\u66f4\u597d\u7684\u8010\u53d7\u6027\u3002\u7136\u800c\uff0c\u8fd9\u4e9b\u836f\u7269\u5f15\u53d1\u7684\u4e0d\u826f\u4e8b\u4ef6\u4e5f\u9700\u8981\u7c7b\u4f3c\u7684\u7ba1\u7406\u65b9\u6cd5\u3002<\/p>\n

\u7ba1\u7406\u6307\u5357\u4e3a\u4e0d\u540c\u5668\u5b98\u6216\u7cfb\u7edf\u7684\u4e0d\u826f\u53cd\u5e94\u63d0\u4f9b\u4e86\u7279\u5b9a\u7684\u5904\u7406\u65b9\u6cd5\u3002\u901a\u5e38\uff0c\u6d89\u53ca\u7684\u63aa\u65bd\u5305\u62ec\u505c\u6b62\u514d\u75ab\u6cbb\u7597\u5e76\u5f00\u59cb\u4f7f\u7528\u7c7b\u56fa\u9187\u8fdb\u884c\u514d\u75ab\u6291\u5236\uff0c\u5176\u5242\u91cf\u548c\u6cbb\u7597\u65f6\u957f\u6839\u636e\u4e0d\u826f\u4e8b\u4ef6\u7684\u4e25\u91cd\u7a0b\u5ea6\u548c\u7c7b\u578b\u800c\u5b9a\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5bf9\u4e8e1\u7ea7\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5efa\u8bae\u4ec5\u8fdb\u884c\u5bf9\u75c7\u6cbb\u7597\u30022\u7ea7\u4e0d\u826f\u4e8b\u4ef6\u9700\u8981\u6682\u505c\u514d\u75ab\u6cbb\u7597\uff0c\u5e76\u4e14\u5982\u679c\u75c7\u72b6\u6301\u7eed\uff0c\u5219\u5e94\u5728\u51fa\u73b0\u75c7\u72b6\u540e\u4e00\u5468\u5185\u5f00\u59cb\u53e3\u670d\u7c7b\u56fa\u9187\u6cbb\u7597\uff08\u4f8b\u5982\uff0c\u5f3a\u7684\u677e0.5-1 mg\/kg\/\u5929\u6216\u7b49\u6548\u5242\u91cf\uff09\u3002\u53ea\u6709\u5728\u4e0d\u826f\u4e8b\u4ef6\u51cf\u8f7b\u81f31\u7ea7\u6216\u5b8c\u5168\u6d88\u5931\u540e\uff0c\u624d\u53ef\u8003\u8651\u6062\u590d\u514d\u75ab\u6cbb\u7597\u3002\u5bf9\u4e8e3\u81f34\u7ea7\u7684\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5e94\u7acb\u5373\u7ed9\u4e88\u9ad8\u5242\u91cf\u7684\u7cd6\u76ae\u8d28\u6fc0\u7d20\uff08\u4f8b\u5982\uff0c\u5f3a\u7684\u677e1-2 mg\/kg\/\u5929\uff09\uff0c\u5e76\u5728\u75c7\u72b6\u51cf\u8f7b\u81f31\u7ea7\u4ee5\u4e0b\u65f6\u9010\u6e10\u51cf\u5c11\u5242\u91cf\u3002\u5bf9\u4e8e\u8fd9\u4e9b\u9ad8\u7ea7\u522b\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5e94\u6c38\u4e45\u505c\u6b62\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6cbb\u7597\u3002<\/p>\n

\u5728\u5bf9\u5927\u5242\u91cf\u76ae\u8d28\u7c7b\u56fa\u9187\u6cbb\u7597\u65e0\u53cd\u5e94\u7684\u4e25\u91cd\u6bd2\u6027\u75c5\u4f8b\u4e2d\uff0c\u5e94\u8003\u8651\u4f7f\u7528\u82f1\u592b\u5229\u6614\u5355\u6297\uff08infliximab\uff0c5 mg\/kg\uff09\uff0c\u4e00\u79cd\u9488\u5bf9\u80bf\u7624\u574f\u6b7b\u56e0\u5b50\u03b1\uff08TNF-\u03b1\uff09\u7684\u5d4c\u5408\u5355\u514b\u9686\u6297\u4f53\u3002\u6b64\u836f\u7269\u7684\u4f7f\u7528\u80cc\u666f\u5305\u62ec\u5176\u5728\u6cbb\u7597\u81ea\u8eab\u514d\u75ab\u6027\u75be\u75c5\u5982\u514b\u7f57\u6069\u75c5\u548c\u6e83\u75a1\u6027\u7ed3\u80a0\u708e\u4e2d\u7684\u5e94\u7528\u3002\u7ec4\u7ec7\u5b66\u7814\u7a76\u663e\u793a\uff0c\u4f0a\u5339\u5355\u6297\u5f15\u8d77\u7684\u514d\u75ab\u76f8\u5173\u7ed3\u80a0\u708e\u4e2d\u7684\u7ed3\u80a0\u9ecf\u819c\u6d78\u6da6\u4e86\u6dcb\u5df4\u7ec6\u80de\u548c\u4e2d\u6027\u7c92\u7ec6\u80de\uff0c\u8fd9\u4e0e\u7279\u53d1\u6027\u6e83\u75a1\u6027\u7ed3\u80a0\u708e\u7c7b\u4f3c\u3002\u65e9\u671f\u4f7f\u7528\u8fd9\u4e9b\u836f\u7269\u53ef\u4ee5\u8fc5\u901f\u7f13\u89e3\u4e0d\u826f\u4e8b\u4ef6\uff0c\u51cf\u5c11\u957f\u671f\u4f9d\u8d56\u76ae\u8d28\u7c7b\u56fa\u9187\u7684\u9700\u8981\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4f7f\u7528\u76ae\u8d28\u7c7b\u56fa\u9187\u6cbb\u7597\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAEs\uff09\u4f3c\u4e4e\u4e0d\u4f1a\u5f71\u54cd\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u7684\u6cbb\u7597\u6548\u679c\u3002\u6839\u636e\u7eaa\u5ff5\u65af\u9686\u51ef\u7279\u7433\u764c\u75c7\u4e2d\u5fc32011\u5e744\u6708\u81f32013\u5e747\u6708\u671f\u95f4\u5bf9298\u540d\u63a5\u53d7\u4f0a\u5339\u5355\u6297\uff083 mg\/kg\uff09\u6cbb\u7597\u7684\u60a3\u8005\u7684\u6570\u636e\uff0c103\u540d\u60a3\u8005\uff08\u536035%\uff09\u9700\u8981\u4f7f\u7528\u76ae\u8d28\u7c7b\u56fa\u9187\u5904\u7406irAEs\uff0c\u5176\u4e2d29\u540d\uff08\u536010%\uff09\u5bf9\u7c7b\u56fa\u9187\u6cbb\u7597\u672a\u8fc5\u901f\u53cd\u5e94\uff0c\u9700\u8981\u4f7f\u7528\u6297TNF\u6cbb\u7597\u3002\u8fd9\u4e9b\u514d\u75ab\u6291\u5236\u6cbb\u7597\u5e76\u672a\u5f71\u54cd\u60a3\u8005\u7684\u603b\u751f\u5b58\u671f\uff08OS\uff09\u6216\u6cbb\u7597\u5931\u8d25\u65f6\u95f4\u3002<\/p>\n

\u5173\u4e8e\u514d\u75ab\u6291\u5236\u5242\u662f\u5426\u4f1a\u5f71\u54cdPD-1\u6291\u5236\u5242\u7684\u6cbb\u7597\u6548\u679c\u7684\u6570\u636e\u76f8\u5bf9\u8f83\u5c11\uff0c\u4f46\u73b0\u6709\u6570\u636e\u663e\u793a\uff0c\u4f7f\u7528\u514d\u75ab\u6291\u5236\u6cbb\u7597\u5904\u7406irAEs\u5e76\u672a\u663e\u8457\u964d\u4f4ePD-1\u6291\u5236\u5242\u7684\u7597\u6548\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\u4e0e\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u7597\u6548\u4e4b\u95f4\u7684\u5173\u7cfb\u4ecd\u6709\u4e89\u8bae\u3002\u65e9\u671f\u4f0a\u5339\u5355\u6297\u7684\u4e34\u5e8a\u8bd5\u9a8c\u6570\u636e\u663e\u793a\uff0c\u51fa\u73b0irAEs\u7684\u60a3\u8005\u5f80\u5f80\u4e34\u5e8a\u83b7\u76ca\u66f4\u5927\u3002\u4e00\u9879\u5bf9\u4e09\u9879II\u671f\u7814\u7a76\u7684\u6c47\u603b\u5206\u6790\u663e\u793a\uff0c\u672a\u51fa\u73b0irAEs\u6216irAEs\u8f83\u8f7b\u7684\u60a3\u8005\u7684\u75be\u75c5\u63a7\u5236\u7387\uff08DCR\uff09\u4e3a20%-24%\uff0c\u800cirAEs\u81f3\u5c11\u4e3a2\u7ea7\u7684\u60a3\u8005DCR\u4e3a34%-43%\u3002\u8fd9\u4e24\u7ec4\u60a3\u8005\u7684\u5e73\u5747\u751f\u5b58\u65f6\u95f4\uff08OS\uff09\u5206\u522b\u4e3a8.2\u4e2a\u6708\u548c14.8\u4e2a\u6708\u3002\u6b64\u5916\uff0c\u4e24\u9879\u9488\u5bf9\u9ad8\u5371\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u7684\u8f85\u52a9\u6cbb\u7597\u8bd5\u9a8c\u53d1\u73b0\uff0c\u65e0\u590d\u53d1\u751f\u5b58\u7387\u4e0eirAEs\u4e4b\u95f4\u5b58\u5728\u663e\u8457\u7684\u76f8\u5173\u6027\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u4e00\u9879\u9488\u5bf9135\u540d\u63a5\u53d7PD-1\u6291\u5236\u5242\u6cbb\u7597\u7684\u975e\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u56de\u987e\u6027\u7814\u7a76\u53d1\u73b0\uff0c\u5ba2\u89c2\u7f13\u89e3\u7387\uff08ORR\uff09\u6216OS\u4e0eirAEs\u7684\u53d1\u751f\u7387\u6216\u7c7b\u56fa\u9187\u7684\u4f7f\u7528\u4e4b\u95f4\u65e0\u663e\u8457\u76f8\u5173\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u82f1\u592b\u5229\u6614\u5355\u6297\u7684\u4f5c\u7528\u673a\u5236\u4e3b\u8981\u662f\u963b\u65ad\u80bf\u7624\u574f\u6b7b\u56e0\u5b50\uff08TNF\uff09\u5411\u708e\u75c7\u90e8\u4f4d\u62db\u52df\u4e2d\u6027\u7c92\u7ec6\u80de\u7684\u80fd\u529b\uff0c\u8fd9\u4e00\u673a\u5236\u4e0d\u592a\u53ef\u80fd\u5f71\u54cd\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u7684\u6297\u80bf\u7624\u6d3b\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/p>\n<\/section>\n<\/section>\n

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33.5 \u5668\u5b98\u7279\u5f02\u6027\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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33.5.1 \u76ae\u80a4\u6bd2\u6027<\/p>\n<\/section>\n

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\u76ae\u80a4\u8868\u73b0\uff0c\u5305\u62ec\u76ae\u75b9\u3001\u7619\u75d2\u548c\u7c98\u819c\u708e\uff0c\u662f\u4e0e\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u76f8\u5173\u7684\u6700\u5e38\u89c1\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAEs\uff09\u3002\u4f7f\u7528\u6297CTLA-4\u6297\u4f53\u7684\u60a3\u8005\u4e2d\u7ea6\u670947%-68%\u51fa\u73b0\u4e0d\u540c\u7a0b\u5ea6\u7684\u76ae\u80a4\u6bd2\u6027\uff0c\u800c\u4f7f\u7528\u6297PD-1\u6216\u6297PD-L1\u6297\u4f53\u7684\u60a3\u8005\u5219\u7ea6\u670930%-40%\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8fd9\u4e9b\u76ae\u75b9\u901a\u5e38\u8868\u73b0\u4e3a\u7f51\u72b6\u6216\u6591\u75b9\u72b6\uff0c\u4f34\u6709\u8f7b\u5ea6\u7ea2\u6591\uff0c\u5c24\u5176\u5e38\u89c1\u4e8e\u8eaf\u5e72\u548c\u56db\u80a2\uff0c\u5e76\u53ef\u80fd\u4f34\u6709\u7619\u75d2\u611f(Fig <\/span>33.2<\/span>)\u3002\u5927\u591a\u6570\u514d\u75ab\u76f8\u5173\u7684\u76ae\u75b9\u53ef\u4ee5\u901a\u8fc7\u4f7f\u7528\u57fa\u4e8e\u76ae\u8d28\u7c7b\u56fa\u9187\u7684\u5916\u7528\u836f\u818f\u8fdb\u884c\u6cbb\u7597\u3002\u6301\u7eed\u7684\u7619\u75d2\u5219\u53ef\u80fd\u9700\u8981\u53e3\u670d\u6297\u7ec4\u80fa\u836f\u7269\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/p>\n<\/section>\n<\/section>\n

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Fig 33.2 <\/span>\u4f0a\u5339\u5355\u6297\u6cbb\u7597\u60a3\u8005\u7684\u76ae\u80a4\u76ae\u75b9<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5bf9\u4e8e\u66f4\u4e25\u91cd\u76842\u7ea7\u76ae\u75b9\uff0c\u5c24\u5176\u662f\u5df2\u7ecf\u5b58\u5728\u7684\u60c5\u51b5\u4e0b\uff0c\u53ef\u80fd\u9700\u8981\u53e3\u670d\u7c7b\u56fa\u9187\u6cbb\u7597\u3002\u800c\u5bf9\u4e8e3\u7ea7\u81f34\u7ea7\u7684\u4e25\u91cd\u76ae\u80a4\u53cd\u5e94\uff0c\u9700\u6682\u505c\u76f8\u5173\u7684\u514d\u75ab\u6cbb\u7597\uff0c\u5e76\u5f00\u59cb\u9759\u8109\u6ce8\u5c04\u7cd6\u76ae\u8d28\u6fc0\u7d20\u3002\u5efa\u8bae\u5728\u8fd9\u4e9b\u60c5\u51b5\u4e0b\u54a8\u8be2\u76ae\u80a4\u79d1\u533b\u751f\uff0c\u5e76\u5728\u53ef\u80fd\u7684\u60c5\u51b5\u4e0b\u8fdb\u884c\u76ae\u80a4\u6d3b\u68c0\u4ee5\u8fdb\u4e00\u6b65\u8bca\u65ad\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u53f2\u8482\u6587\u65af-\u7ea6\u7ff0\u900a\u7efc\u5408\u5f81\uff08Stevens-Johnson Syndrome\uff09\u662f\u4e00\u79cd\u8f83\u4e3a\u7f55\u89c1\u4f46\u6f5c\u5728\u81f4\u547d\u7684\u75be\u75c5(Fig 33.3<\/span>)\u3002\u5bf9\u4e8e\u8fd9\u79cd\u60c5\u51b5\uff0c\u5efa\u8bae\u7acb\u5373\u91c7\u7528\u9759\u8109\u6ce8\u5c04\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6cbb\u7597\u3002\u5982\u679c\u75c7\u72b6\u6ca1\u6709\u6539\u5584\uff0c\u5e94\u8003\u8651\u8054\u5408\u4f7f\u7528\u514d\u75ab\u6291\u5236\u5242\u548c\u76ae\u8d28\u7c7b\u56fa\u9187\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 33.3 <\/span>Stevens-Johnson\u7efc\u5408\u5f81<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u767d\u765c\u98ce\u662f\u53e6\u4e00\u79cd\u5e38\u89c1\u75c5\u75c7\uff0c\u901a\u5e38\u5728\u63a5\u53d7\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6cbb\u7597\u540e\u51fa\u73b0\u3002\u5176\u7279\u5f81\u662f\u771f\u76ae\u6df1\u5c42\u8840\u7ba1\u5468\u56f4\u6dcb\u5df4\u7ec6\u80de\u7684\u6d78\u6da6\uff0c\u9760\u8fd1\u9ed1\u7d20\u7ec6\u80de\uff0c\u88ab\u8ba4\u4e3a\u662f\u5bf9\u6cbb\u7597\u7684\u514d\u75ab\u53cd\u5e94\u7684\u4e00\u4e2a\u6807\u5fd7\u3002\u4e0e\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u76f8\u6bd4\uff0c\u4f7f\u7528\u6297PD-1\u6297\u4f53\u7684\u60a3\u8005\u66f4\u5bb9\u6613\u51fa\u73b0\u53e3\u8154\u7c98\u819c\u708e\uff0c\u901a\u5e38\u9700\u8981\u4f7f\u7528\u5c40\u90e8\u76ae\u8d28\u7c7b\u56fa\u9187\u548c\u5229\u591a\u5361\u56e0\u8fdb\u884c\u6cbb\u7597\uff0c\u5e76\u5728\u6392\u9664\u4e86\u5ff5\u73e0\u83cc\u611f\u67d3\u540e\u8fdb\u884c(Fig 33.4<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 33.4 <\/span>\u6297PD-1\u6cbb\u7597\u5f15\u8d77\u7684\u9ecf\u819c\u708e<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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33.5.2 \u80c3\u80a0\u9053\u6bd2\u6027<\/p>\n<\/section>\n

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\u8179\u6cfb\u662f\u63a5\u53d7\u514d\u75ab\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\u5e38\u89c1\u7684\u4e00\u79cd\u526f\u4f5c\u7528\uff0c\u4e14\u9700\u53ca\u65f6\u8bca\u65ad\u548c\u6cbb\u7597\u4ee5\u9632\u6b62\u53d1\u5c55\u6210\u4e25\u91cd\u4e0d\u826f\u4e8b\u4ef6\u3002\u901a\u5e38\uff0c\u8179\u6cfb\u4f1a\u5728\u6cbb\u7597\u5f00\u59cb\u540e6\u5468\u5185\u51fa\u73b0\uff0c\u4f7f\u7528\u6297CTLA-4\u6297\u4f53\uff08\u5982\u4f0a\u5339\u5355\u6297\uff09\u7684\u60a3\u8005\u4e2d\u8179\u6cfb\u7684\u53d1\u751f\u7387\u66f4\u9ad8\uff0c\u4e0e\u6297PD-1\/PD-L1\u6297\u4f53\u76f8\u6bd4\u5c24\u4e3a\u660e\u663e\u3002\u636e\u62a5\u9053\uff0c\u63a5\u53d7\u4f0a\u5339\u5355\u6297\u6cbb\u7597\u7684\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u4e2d\uff0c\u5927\u7ea630%\u4f1a\u51fa\u73b0\u8179\u6cfb\uff0c\u5176\u4e2d3-4\u7ea7\u7684\u4e25\u91cd\u8179\u6cfb\u6bd4\u4f8b\u4e0d\u8db310%\u3002\u5728\u4e00\u9879\u9488\u5bf9\u4f0a\u5339\u5355\u6297\u7684II\u671f\u7814\u7a76\u4e2d\uff0c10 mg\/kg\u5242\u91cf\u7ec4\u7684\u4e25\u91cd\u8179\u6cfb\u53d1\u751f\u7387\u9ad8\u4e8e3 mg\/kg\u7ec4\uff0810%\u5bf9\u6bd41%\uff09\u3002\u5728III\u671f\u7814\u7a76\u4e2d\uff0c\u540c\u6837\u7684\u8d8b\u52bf\u4e5f\u88ab\u89c2\u5bdf\u5230\uff0c\u5176\u4e2d10 mg\/kg\u7ec4\u7684\u80c3\u80a0\u9053\u6bd2\u6027\u9ad8\u4e8e3 mg\/kg\u7ec4\uff0c\u524d\u8005\u670979%\u7684\u60a3\u8005\u62a5\u544a\u8179\u6cfb\uff0c\u800c\u540e\u8005\u4e3a64%\uff0c\u4e1410 mg\/kg\u7ec4\u76843-4\u7ea7\u8179\u6cfb\u53d1\u751f\u7387\u662f3 mg\/kg\u7ec4\u7684\u8fd1\u4e24\u500d\uff0834%\u5bf9\u6bd418%\uff09\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u5728\u4f7f\u7528\u6297PD-1\u836f\u7269\u7684\u60a3\u8005\u4e2d\uff0c\u4ec5\u67091-2%\u7684\u60a3\u8005\u51fa\u73b03-4\u7ea7\u8179\u6cfb\u3002\u80c3\u80a0\u9053\u6bd2\u6027\u662f\u8054\u5408\u4f7f\u7528\u5c3c\u4f0f\u5355\u6297\u548c\u4f0a\u5339\u5355\u6297\u7684\u4e3b\u8981\u4e0d\u826f\u4e8b\u4ef6\uff0c\u53d1\u751f\u7387\u7ea6\u4e3a40%\uff0c\u5176\u4e2d\u7ea69%\u7684\u60a3\u8005\u51fa\u73b0\u4e25\u91cd\u8179\u6cfb\u548c\u7ed3\u80a0\u708e\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6709\u65f6\u80a0\u708e\u751a\u81f3\u5728\u6ca1\u6709\u8179\u6cfb\u7684\u60c5\u51b5\u4e0b\u4e5f\u53ef\u80fd\u5f15\u8d77\u5c0f\u80a0\u6897\u963b\u3002\u6d3b\u68c0\u8868\u73b0\u4e3a\u6c34\u80bf\u7684\u7c98\u819c\u4f34\u6709\u5927\u91cf\u4e2d\u6027\u7c92\u7ec6\u80de\u548c\/\u6216\u6dcb\u5df4\u7ec6\u80de\u7684\u6d78\u6da6\u3002\u76ee\u524d\u5c1a\u65e0\u6709\u6548\u7684\u9884\u9632\u63aa\u65bd\u6765\u963b\u6b62\u8179\u6cfb\u6216\u7ed3\u80a0\u708e\u7684\u53d1\u5c55\u3002\u4f7f\u7528\u5e03\u5730\u5948\u5fb7\u7b49\u836f\u7269\u6cbb\u7597\u80a0\u708e\u5df2\u8fdb\u884c\u8bc4\u4f30\uff0c\u4f46\u672a\u663e\u793a\u663e\u8457\u6548\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u5904\u7406\u8179\u6cfb\u65f6\uff0c\u786e\u4fdd\u9002\u5f53\u7684\u6c34\u5206\u8865\u5145\u81f3\u5173\u91cd\u8981\uff0c\u5e76\u9700\u6392\u67e5\u5176\u4ed6\u53ef\u80fd\u5bfc\u81f4\u8179\u6cfb\u7684\u539f\u56e0\uff0c\u5982\u8270\u96be\u68ad\u83cc\u611f\u67d3\u3002\u5bf9\u4e8e1\u7ea7\u8179\u6cfb\uff0c\u901a\u5e38\u4f7f\u7528\u6d1b\u54cc\u4e01\u80fa\u8fdb\u884c\u5bf9\u75c7\u6cbb\u7597\u5df2\u8db3\u591f\u3002\u5bf9\u4e8e2\u7ea7\u8179\u6cfb\uff0c\u5e94\u6682\u505c\u514d\u75ab\u6cbb\u7597\u5e76\u4f7f\u7528\u53e3\u670d\u76ae\u8d28\u7c7b\u56fa\u9187\uff08\u5982\u5f3a\u7684\u677e0.5-1 mg\/kg\/\u5929\u6216\u7b49\u6548\u5242\u91cf\uff09\u3002\u82e5\u75c5\u60c5\u7f13\u89e3\uff0c\u53ef\u4ee5\u6062\u590d\u6cbb\u7597\uff1b\u82e5\u57283-5\u5929\u5185\u672a\u7f13\u89e3\uff0c\u5e94\u6309\u71673-4\u7ea7\u4e8b\u4ef6\u5904\u7406\uff0c\u5305\u62ec\u4f7f\u7528\u9ad8\u5242\u91cf\u9759\u8109\u6ce8\u5c04\u76ae\u8d28\u7c7b\u56fa\u9187\uff08\u5982\u7532\u57fa\u5f3a\u7684\u677e\u9f991-2 mg\/kg\/\u5929\uff09\u548c\u9884\u9632\u6027\u6297\u751f\u7d20\u6cbb\u7597\u3002\u5982\u679c\u5bf9\u9ad8\u5242\u91cf\u76ae\u8d28\u7c7b\u56fa\u9187\u6cbb\u7597\u65e0\u53cd\u5e94\uff0c\u5219\u5efa\u8bae\u4f7f\u7528\u82f1\u592b\u5229\u6614\u5355\u62975 mg\/kg\uff0c\u5e76\u57282\u5468\u540e\u89c6\u60c5\u51b5\u53ef\u80fd\u91cd\u590d\u4f7f\u7528\u3002\u56e0\u9ad8\u80a0\u7a7f\u5b54\u98ce\u9669\uff0c\u60a3\u8005\u5e94\u63a5\u53d7\u4e34\u5e8a\u76d1\u6d4b\u3002\u6297CTLA-4\u548c\/\u6216\u6297PD-1\u6cbb\u7597\u5e94\u6c38\u4e45\u505c\u7528\u3002<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\u672c\u6587\u7531Oncolab\u5fae\u4fe1\u516c\u4f17\u53f7\u7ffb\u8bd1\u6574\u7406\u81eaOncoimmunology: A Practical Guide for Cancer Immunotherapy\uff0c\u4ec5\u7528\u4e8e\u5b66\u4e60\u4ea4\u6d41\u4f7f\u7528\uff0c\u5982\u9700\u8d2d\u4e70\u539f\u7248\u4e66\u7c4d\u53ef\u70b9\u51fb\u9605\u8bfb\u539f\u6587\u8d2d\u4e70\u3002<\/span>
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\u2014 THE  END \u2014<\/span><\/p>\n


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\u6765\u6e90 | Oncoimmunology: A Practical Guide <\/span><\/p>\n

for Cancer Immunotherapy<\/span><\/p>\n

\u521d\u7a3f\u7ffb\u8bd1 | \u7f57\u8377<\/span><\/p>\n

\u56fe\u6587\u6392\u7248 | \u5e94\u6b63 \u8d75\u6829<\/span><\/span><\/p>\n

\u5ba1\u6838\u4fee\u6539 | \u738b\u5764<\/span><\/p>\n

\uff08\u8f6c\u8f7d\u8bf7\u4fdd\u7559\u6b64\u90e8\u5206\u5185\u5bb9\uff09<\/span><\/strong><\/p>\n

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\u2589  \u5f80\u671f\u63a8\u9001\u5408\u8f91<\/strong><\/strong><\/section>\n
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\u80bf\u7624\u514d\u75ab\u5b66\u6700\u65b0\u6587\u732e<\/span><\/a>
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\u514d\u75ab\u5b66\u62fe\u9057\u7cfb\u5217<\/a><\/span><\/p>\n

\u80bf\u7624\u514d\u75ab\u5b66\u7cfb\u5217<\/span><\/a><\/p>\n

ACIR\u6587\u732e\u901f\u9012<\/span><\/a><\/p>\n

SCI\u8bba\u6587\u4f5c\u56fe<\/span><\/a><\/p>\n

SCI\u8bba\u6587\u5199\u4f5c\u53ca\u6295\u7a3f<\/span><\/a><\/p>\n

\u751f\u4fe1\u5165\u95e8\u5b66\u4e60\u7b14\u8bb0<\/span><\/a><\/p>\n

R\u8bed\u8a00\u57fa\u7840\u4e0e\u5355\u7ec6\u80de\u5206\u6790\u5b9e\u6218\u89c6\u9891\u8bfe\u7a0b<\/span><\/a><\/p>\n

\u751f\u7269\u5b66\u5b9e\u9a8c\u6280\u672f\u53ca\u5e38\u7528\u8f6f\u4ef6<\/span><\/a><\/p>\n

RCIM\u4eea\u5668\u7b80\u4ecb\u53ca\u64cd\u4f5c\u89c6\u9891<\/a><\/span><\/p>\n

\u5e38\u7528\u7535\u8111\u8f6f\u4ef6\u4f7f\u7528\u6559\u7a0b<\/a><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u5173\u6ce8\u672c\u53f7~<\/span>
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\u52a0\u5165\u8bfb\u8005\u4ea4\u6d41\u7fa4~<\/span><\/p>\n

\uff08\u6dfb\u52a0\u8bf7\u5907\u6ce8\u5355\u4f4d\u59d3\u540d\uff09<\/span><\/p>\n


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\u52a0\u5165\u77e5\u8bc6\u661f\u7403~<\/span><\/p>\n


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<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\u70b9\u4eae\u8d5e\u4e0e\u5728\u770b <\/span><\/p>\n

\u8ba9\u66f4\u591a\u4eba\u770b\u5230<\/span><\/p>\n

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\u672c\u7bc7\u6587\u7ae0\u6765\u6e90\u4e8e\u5fae\u4fe1\u516c\u4f17\u53f7: OncoLab <\/p>\n<\/blockquote>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

\u4e0a\u671f\u5185\u5bb9\uff1a\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c32\u7ae0\uff1a1\u671f\u8bd5\u9a8c\u4e2d\u7684\u514d\u75ab\u7597\u6cd5\uff08\u4e0b\uff09 33.1 \u7b80\u4ecb \u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u662f\u4e00\u7c7b\u514d\u75ab\u8c03\u8282\u836f\u7269…<\/p>\n","protected":false},"author":1,"featured_media":3622,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[65],"tags":[],"_links":{"self":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts\/3627"}],"collection":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/comments?post=3627"}],"version-history":[{"count":0,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts\/3627\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/media\/3622"}],"wp:attachment":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/media?parent=3627"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/categories?post=3627"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/tags?post=3627"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}