{"id":3635,"date":"2024-08-13T17:47:49","date_gmt":"2024-08-13T09:47:49","guid":{"rendered":"http:\/\/oncolab.cn\/index.php\/2024\/08\/13\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac35%e7%ab%a0-%e5%89%8d%e5%88%97%e8%85%ba%e7%99%8c%e7%9a%84%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%ef%bc%9a%e4%b8%80%e4%b8%aa%e4%b8%8d%e6%96%ad\/"},"modified":"2024-08-13T17:47:49","modified_gmt":"2024-08-13T09:47:49","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac35%e7%ab%a0-%e5%89%8d%e5%88%97%e8%85%ba%e7%99%8c%e7%9a%84%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%ef%bc%9a%e4%b8%80%e4%b8%aa%e4%b8%8d%e6%96%ad","status":"publish","type":"post","link":"http:\/\/oncolab.cn\/index.php\/2024\/08\/13\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac35%e7%ab%a0-%e5%89%8d%e5%88%97%e8%85%ba%e7%99%8c%e7%9a%84%e5%85%8d%e7%96%ab%e6%b2%bb%e7%96%97%ef%bc%9a%e4%b8%80%e4%b8%aa%e4%b8%8d%e6%96%ad\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c35\u7ae0 \u524d\u5217\u817a\u764c\u7684\u514d\u75ab\u6cbb\u7597\uff1a\u4e00\u4e2a\u4e0d\u65ad\u53d1\u5c55\u7684\u9886\u57df\uff08\u4e0a\uff09"},"content":{"rendered":"
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\u4e0a\u671f\u5185\u5bb9\uff1a\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c34\u7ae0 \u665a\u671f\u53ca\u8f85\u52a9\u6cbb\u7597\u4e2d\u9ed1\u8272\u7d20\u7624\u7684\u514d\u75ab\u6cbb\u7597\u7b56\u7565\uff08\u4e0b\uff09<\/span><\/a><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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35.1 \u524d\u8a00<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5168\u7403\u8303\u56f4\u5185\uff0c\u524d\u5217\u817a\u764c\u662f\u7537\u6027\u4e2d\u7b2c\u4e8c\u5e38\u89c1\u7684\u764c\u75c7\uff0c2012\u5e74\u7ea6\u6709110\u4e07\u4f8b\u65b0\u53d1\u75c5\u4f8b\u548c30.7\u4e07\u4f8b\u6b7b\u4ea1\u75c5\u4f8b\u3002\u8be5\u75be\u75c5\u4e3b\u8981\u53d1\u751f\u572865\u5c81\u4ee5\u4e0a\u7684\u8001\u5e74\u7537\u6027\u4e2d\u3002\u5bf9\u4e8e\u4e34\u5e8a\u5c40\u9650\u6027\u524d\u5217\u817a\u764c\uff0c\u6807\u51c6\u6cbb\u7597\u65b9\u6848\u901a\u5e38\u5305\u62ec\u6839\u6cbb\u6027\u524d\u5217\u817a\u5207\u9664\u672f\u548c\/\u6216\u653e\u5c04\u6cbb\u7597\u3002\u96c4\u6fc0\u7d20\u5265\u593a\u7597\u6cd5\uff0c\u5982\u53cc\u4fa7\u53bb\u52bf\u672f\u6216LHRH\u6fc0\u52a8\u5242\u6216\u6297\u96c4\u6fc0\u7d20\u836f\u7269\u7684\u5e94\u7528\uff0c\u53ef\u4ee5\u51cf\u5c11\u80bf\u7624\u8d1f\u62c5\uff0c\u5e76\u5ef6\u957f\u60a3\u8005\u7684\u4e2d\u4f4d\u65e0\u8fdb\u5c55\u751f\u5b58\u671f12\u81f318\u4e2a\u6708\u3002<\/p>\n

\u5c3d\u7ba1\u521d\u671f\u6fc0\u7d20\u6cbb\u7597\u80fd\u591f\u6709\u6548\u63a7\u5236\u75be\u75c5\uff0c\u4f46\u5927\u591a\u6570\u60a3\u8005\u6700\u7ec8\u4f1a\u8fdb\u5c55\u4e3a\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\uff08CRPC\uff09(Fig <\/span>35.1<\/span>)\uff0c\u5176\u4e2d\u7ea670%\u7684\u60a3\u8005\u4f1a\u53d1\u751f\u8f6c\u79fb\uff0c\u800c\u5728\u8fd9\u4e9b\u8f6c\u79fb\u75c5\u4f8b\u4e2d\uff0c80%\u81f390%\u4f1a\u7d2f\u53ca\u9aa8\u9abc\u3002\u76ee\u524d\uff0c\u5c3d\u7ba1\u6709\u591a\u79cd\u6cbb\u7597\u65b9\u6cd5\u53ef\u4ee5\u5ef6\u957f\u60a3\u8005\u7684\u751f\u5b58\u671f\u5e76\u63d0\u4f9b\u59d1\u606f\u6cbb\u7597\uff0c\u4f46\u5c1a\u65e0\u6cbb\u6108\u8f6c\u79fb\u6027\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\uff08mCRPC\uff09\u7684\u65b9\u6cd5\u3002<\/p>\n

\u5bf9\u4e8emCRPC\u60a3\u8005\uff0c\u4e00\u7ebf\u6cbb\u7597\u65b9\u6848\u5305\u62ec\u6297\u96c4\u6fc0\u7d20\u836f\u7269\u6069\u6742\u9c81\u80fa\uff08enzalutamide\uff09\u548c\u918b\u9178\u963f\u6bd4\u7279\u9f99\uff08abiraterone acetate\uff09\uff0c\u4ee5\u53ca\u5316\u7597\u836f\u7269\u591a\u897f\u4ed6\u8d5b\uff08docetaxel\uff09\u3002mCRPC\u60a3\u8005\u7684\u9884\u540e\u56e0\u4e2a\u4f53\u5dee\u5f02\u800c\u5f02\uff0c\u4e2d\u4f4d\u603b\u751f\u5b58\u671f\uff08OS\uff09\u7ea6\u4e3a16\u81f334\u4e2a\u6708(Fig <\/span>35.1<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 35.1<\/span> \u663e\u793a\u4e86\u524d\u5217\u817a\u764c\u4ece\u521d\u6b21\u8bca\u65ad\u5230\u60a3\u8005\u6b7b\u4ea1\u7684\u75be\u75c5\u8fdb\u5c55\u8fc7\u7a0b\u3002\u624b\u672f\u548c\u653e\u7597\u7b49\u5c40\u90e8\u6cbb\u7597\u624b\u6bb5\u53ef\u4ee5\u6709\u6548\u63a7\u5236\u65e9\u671f\u75be\u75c5\u3002\u5bf9\u4e8e\u521d\u6b21\u63a5\u53d7\u6cbb\u7597\u7684\u96c4\u6fc0\u7d20\u4f9d\u8d56\u6027\u80bf\u7624\uff0c\u6297\u96c4\u6fc0\u7d20\u6cbb\u7597\u901a\u5e38\u80fd\u5e26\u6765\u663e\u8457\u7684\u4e34\u5e8a\u83b7\u76ca\u3002\u7136\u800c\uff0c\u4e00\u65e6\u75be\u75c5\u8fdb\u5c55\u81f3\u665a\u671f\u8f6c\u79fb\u6027\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\uff0c\u60a3\u8005\u7684\u9884\u540e\u8f83\u5dee\uff0c\u4e14\u53ef\u4f9b\u9009\u62e9\u7684\u6cbb\u7597\u65b9\u6848\u975e\u5e38\u6709\u9650\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u8fc7\u53bb\u51e0\u5e74\u4e2d\uff0c\u514d\u75ab\u6cbb\u7597\u5df2\u6210\u4e3a\u591a\u79cd\u5b9e\u4f53\u7624\u6cbb\u7597\u4e2d\u6781\u5177\u524d\u666f\u7684\u624b\u6bb5\u4e4b\u4e00\u30022010\u5e74\uff0c\u7f8e\u56fdFDA\u6279\u51c6\u4e86\u6297CTLA-4\u836f\u7269\u4f0a\u5339\u5355\u6297\uff08ipilimumab\uff0c\u6765\u81eaBristol-Myers Squibb\u516c\u53f8\uff0c\u65b0\u6cfd\u897f\u5dde\u666e\u6797\u65af\u987f\uff09\u7528\u4e8e\u6cbb\u7597\u665a\u671f\u9ed1\u8272\u7d20\u7624\uff0c\u6b64\u524d\u7684\u4e00\u9879\u5173\u952e\u6027\u968f\u673aIII\u671f\u8bd5\u9a8c\u663e\u793a\uff0cCTLA-4\u963b\u65ad\u80fd\u591f\u663e\u8457\u63d0\u9ad8\u603b\u4f53\u751f\u5b58\u7387\u3002\u5c3d\u7ba1\u6297CTLA-4\u6cbb\u7597\u5728\u80be\u7ec6\u80de\u764c\u548c\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u4e2d\u4e5f\u8868\u73b0\u51fa\u4e00\u5b9a\u7597\u6548\uff0c\u4f46\u8fd9\u4e9b\u9002\u5e94\u75c7\u5c1a\u672a\u83b7\u5f97\u76d1\u7ba1\u673a\u6784\u7684\u6279\u51c6\u3002<\/p>\n

\u6700\u8fd1\uff0c\u963b\u65adPD-1\/PD-L1\u901a\u8def\u7684\u836f\u7269\u5728\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u3001\u9ed1\u8272\u7d20\u7624\u3001\u80be\u764c\u3001\u5934\u9888\u764c\u7b49\u591a\u79cd\u764c\u75c7\u60a3\u8005\u4e2d\u663e\u793a\u51fa\u5ef6\u957f\u751f\u5b58\u671f\u7684\u6548\u679c\uff0c\u8fd9\u4e5f\u4fc3\u6210\u4e86\u591a\u4e2a\u836f\u7269\u7684\u76d1\u7ba1\u6279\u51c6\u3002\u5728\u591a\u79cd\u80bf\u7624\u7c7b\u578b\u4e2d\uff0cPD-1\/PD-L1\u963b\u65ad\u6240\u5f15\u53d1\u7684\u5ba2\u89c2\u53cd\u5e94\u4f3c\u4e4e\u6bd4\u5316\u7597\u66f4\u6301\u4e45\u3002\u6b64\u5916\uff0c\u5df2\u6709\u4e00\u79cd\u75ab\u82d7\u83b7\u51c6\u7528\u4e8e\u6cbb\u7597\u8f6c\u79fb\u6027\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\uff08mCRPC\uff09\u2014\u2014\u8fd9\u5c31\u662f\u6d3b\u6027\u7ec6\u80de\u7597\u6cd5Sipuleucel-T\uff08\u7531Dendreon\u516c\u53f8\u5f00\u53d1\uff0c\u4f4d\u4e8e\u534e\u76db\u987f\u5dde\u897f\u96c5\u56fe\uff09\u3002<\/p>\n

\u5728\u514d\u75ab\u6cbb\u7597\u7684\u524d\u6cbf\u53d1\u5c55\u4e2d\uff0c\u8fc7\u7ee7\u7ec6\u80de\u6cbb\u7597\u5c24\u5176\u5f15\u4eba\u6ce8\u76ee\uff0c\u7279\u522b\u662fCAR T\u7ec6\u80de\u7597\u6cd5\u5728\u67d0\u4e9b\u767d\u8840\u75c5\u548c\u6dcb\u5df4\u7624\u4e2d\u5c55\u73b0\u51fa\u663e\u8457\u7597\u6548\u3002\u8868\u8fbe\u80bf\u7624\u7279\u5f02\u6027T\u7ec6\u80de\u53d7\u4f53\uff08TCR\uff09\u7684T\u7ec6\u80de\u5728\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u4e2d\u4e5f\u663e\u793a\u51fa\u660e\u663e\u7684\u7597\u6548\uff0c\u5c3d\u7ba1\u5728\u5b9e\u4f53\u7624\u6cbb\u7597\u9886\u57df\uff0c\u8fc7\u7ee7\u7ec6\u80de\u7597\u6cd5\u4ecd\u9762\u4e34\u8bf8\u591a\u6311\u6218\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5c3d\u7ba1\u514d\u75ab\u6cbb\u7597\u5728\u67d0\u4e9b\u764c\u75c7\u4e2d\u53d6\u5f97\u4e86\u663e\u8457\u8fdb\u5c55\uff0c\u4f46\u5728\u665a\u671f\u524d\u5217\u817a\u764c\u7684\u6cbb\u7597\u4e2d\u4ecd\u9762\u4e34\u8bf8\u591a\u6311\u6218\u3002\u5176\u4e2d\u4e00\u4e2a\u4e3b\u8981\u969c\u788d\u662f\u524d\u5217\u817a\u764c\u7684\u80bf\u7624\u514d\u75ab\u539f\u6027\u8f83\u4f4e\uff0c\u4ee5\u53ca\u5176\u80bf\u7624\u5fae\u73af\u5883\uff08TME\uff09\u4e2d\u6d78\u6da6\u6027\u8f83\u5dee\uff08\u76f8\u8f83\u4e8e\u5bf9\u5df2\u83b7\u6279\u836f\u7269\u66f4\u5177\u53cd\u5e94\u6027\u7684\u5176\u4ed6\u80bf\u7624\u7c7b\u578b\uff09(Fig 35.2<\/span>)\u3002\u8fd9\u4e9b\u524d\u5217\u817a\u764cTME\u7684\u7279\u6027\u4f7f\u5f97\u8fd9\u79cd\u764c\u75c7\u96be\u4ee5\u901a\u8fc7\u514d\u75ab\u7597\u6cd5\u8fdb\u884c\u6709\u6548\u6cbb\u7597\uff0c\u4e14\u5728\u5176\u4ed6\u764c\u75c7\u4e2d\u663e\u793a\u51fa\u7597\u6548\u7684\u6cbb\u7597\u624b\u6bb5\u5f80\u5f80\u65e0\u6cd5\u5728mCRPC\u4e2d\u4ea7\u751f\u540c\u6837\u7684\u6548\u679c\u3002<\/p>\n

\u9488\u5bf9PD-1\/PD-L1\u7684\u514d\u75ab\u7597\u6cd5\u5728\u4e34\u5e8a\u4e0a\u7f3a\u4e4f\u5ba2\u89c2\u53cd\u5e94\u7684\u4e00\u4e2a\u5047\u8bbe\u662f\u524d\u5217\u817a\u80bf\u7624\u4e2dPD-L1\u8868\u8fbe\u7684\u76f8\u5bf9\u4e0d\u8db3\uff0c\u8fd9\u53ef\u80fd\u89e3\u91ca\u4e86\u4e3a\u4ec0\u4e48\u963b\u65ad\u6297\u4f53\u5355\u836f\u6cbb\u7597\u901a\u5e38\u65e0\u6548\u3002\u7136\u800c\uff0c\u524d\u5217\u817a\u764c\u4e2d\u5fae\u536b\u661f\u4e0d\u7a33\u5b9a\u6027\uff08MSI\uff09\u80bf\u7624\u53ef\u80fd\u662f\u4e00\u4e2a\u4f8b\u5916\u3002\u5728\u591a\u79cd\u75be\u75c5\u4e2d\uff0c\u5177\u6709MSI\u7684\u80bf\u7624\u5bf9\u514d\u75ab\u7597\u6cd5\u8868\u73b0\u51fa\u66f4\u5f3a\u7684\u53cd\u5e94\u3002\u7136\u800c\uff0c\u4e0d\u5e78\u7684\u662f\uff0c\u5728mCRPC\u4e2d\uff0c\u771f\u6b63\u7684MSI\u75c5\u4f8b\u975e\u5e38\u7f55\u89c1\uff0c\u53d1\u751f\u7387\u4e0d\u52305%\u3002<\/p>\n

\u6b64\u5916\uff0c\u6297CTLA-4\u548c\u6297PD-1\u7684\u8054\u5408\u514d\u75ab\u7597\u6cd5\u5728\u591a\u79cd\u80bf\u7624\u7c7b\u578b\u4e2d\u5df2\u5c55\u73b0\u51fa\u7597\u6548\uff0c\u5e76\u4e14\u6700\u8fd1\u88ab\u7f8e\u56fdFDA\u6279\u51c6\u7528\u4e8e\u6cbb\u7597\u9ed1\u8272\u7d20\u7624\u3002\u8fd9\u79cd\u8054\u5408\u7597\u6cd5\u4e5f\u6b63\u5728\u88ab\u63a2\u7d22\u7528\u4e8e\u524d\u5217\u817a\u764c\uff0c\u4f46\u5176\u6548\u679c\u4ecd\u9700\u8fdb\u4e00\u6b65\u7814\u7a76\u548c\u9a8c\u8bc1\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 35.2<\/span> \u5bf9\u6bd4\u4e86\u524d\u5217\u817a\u764c\u7ec4\u7ec7\u4e0e\u5934\u9888\u90e8\u764c\u7ec4\u7ec7\u4e2dCD8+ T\u7ec6\u80de\u7684\u6d78\u6da6\u6a21\u5f0f\u3002\u514d\u75ab\u7ec4\u5316\u67d3\u8272\u7ed3\u679c\u663e\u793a\uff0c\u76f8\u8f83\u4e8e\u5934\u9888\u90e8\u80bf\u7624\uff0c\u524d\u5217\u817a\u80bf\u7624\u4e2d\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de\uff08CD8+ T\u7ec6\u80de\uff09\u7684\u6d78\u6da6\u663e\u8457\u51cf\u5c11\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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35.2  \u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6b63\u5982\u524d\u6587\u6240\u8ff0\uff0c\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u5728\u591a\u79cd\u5b9e\u4f53\u7624\u4e2d\u5c55\u73b0\u51fa\u4ee4\u4eba\u77a9\u76ee\u7684\u7597\u6548\u3002\u5728\u5178\u578b\u7684\u514d\u75ab\u53cd\u5e94\u4e2d\uff0c\u6d3b\u5316\u7684\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de\u4f1a\u8868\u8fbePD-1\u5206\u5b50\uff0cPD-1\u968f\u540e\u4e0e\u5176\u914d\u4f53PD-L1\u548cPD-L2 (Fig 35.2<\/span>) \u7ed3\u5408\uff0c\u4ece\u800c\u6291\u5236T\u7ec6\u80de\u7684\u589e\u6b96\u548c\u6548\u5e94\u529f\u80fd\u3002\u8fd9\u4e00\u673a\u5236\u53ef\u80fd\u8fdb\u5316\u4e3a\u4e00\u79cd\u9632\u6b62\u514d\u75ab\u53cd\u5e94\u5931\u63a7\u3001\u5f15\u53d1\u81ea\u8eab\u514d\u75ab\u7684\u4fdd\u62a4\u63aa\u65bd\u3002\u7136\u800c\uff0c\u8bb8\u591a\u80bf\u7624\u901a\u8fc7\u4e0a\u8c03\u80bf\u7624\u7ec6\u80de\u672c\u8eab\u6216\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u7684\u9ad3\u6837\u7ec6\u80de\u8868\u9762\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u914d\u4f53\uff08\u5982PD-L1\uff09\uff0c\u5229\u7528\u8fd9\u4e00\u9014\u5f84\u6765\u9003\u907f\u514d\u75ab\u8bc6\u522b\u3002\u56e0\u6b64\uff0c\u963b\u65adPD-1\/PD-L1\u7684\u76f8\u4e92\u4f5c\u7528\u53ef\u80fd\u589e\u5f3a\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u3002<\/p>\n

\u8fd9\u4e00\u673a\u5236\u7684\u53e6\u4e00\u4e2a\u91cd\u8981\u540e\u679c\u662f\uff0c\u80bf\u7624\u7ec6\u80de\u6216\u6d78\u6da6\u80bf\u7624\u7684\u514d\u75ab\u7ec6\u80de\u4e0a\u7684PD-L1\u8868\u8fbe\u6c34\u5e73\uff0c\u53ef\u80fd\u4f5c\u4e3aPD-1\/PD-L1\u963b\u65ad\u7597\u6cd5\u654f\u611f\u6027\u7684\u4e00\u79cd\u6f5c\u5728\u751f\u7269\u6807\u5fd7\u7269\u3002\u7136\u800c\uff0c\u9488\u5bf9\u8fd9\u4e00\u5047\u8bbe\u7684\u591a\u9879\u8bd5\u9a8c\u5f97\u51fa\u4e86\u76f8\u4e92\u77db\u76fe\u7684\u7ed3\u679c\u3002\u4f8b\u5982\uff0c\u5728\u4e00\u9879\u5173\u952e\u6027\u7684\u80be\u764cPD-1\u963b\u65ad\u8bd5\u9a8c\u4e2d\uff0c\u80bf\u7624\u7684PD-L1\u72b6\u6001\u4e0e\u6cbb\u7597\u53cd\u5e94\u4e4b\u95f4\u672a\u663e\u793a\u51fa\u5173\u8054\u6027\u3002\u76f8\u8f83\u4e4b\u4e0b\uff0c\u6297PD-1\u836f\u7269pembrolizumab\uff08\u9ed8\u514b\u516c\u53f8\uff0c\u4f4d\u4e8e\u65b0\u6cfd\u897f\u5ddeKenilworth\uff09\u4ec5\u88ab\u7f8e\u56fdFDA\u6279\u51c6\u7528\u4e8ePD-L1\u9633\u6027\u7684\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u60a3\u8005\u7684\u4e00\u7ebf\u6cbb\u7597\u3002<\/p>\n

\u5728\u524d\u5217\u817a\u764c\u4e2d\uff0cPD-L1\u7684\u8868\u8fbe\u901a\u5e38\u8f83\u4f4e\uff0cmCRPC\u6837\u672c\u4e2d\u5927\u591a\u663e\u793a\u4e3aPD-L1\u9634\u6027\uff0c\u8fd9\u4e5f\u89e3\u91ca\u4e86\u4e3a\u4f55\u8be5\u7c7b\u578b\u80bf\u7624\u5bf9PD-1\/PD-L1\u963b\u65ad\u7597\u6cd5\u7684\u53cd\u5e94\u8f83\u5dee\u3002\u5728\u4e00\u9879\u4f7f\u7528\u6297PD-1\u836f\u7269nivolumab\uff08Bristol-Myers Squibb\u516c\u53f8\uff0c\u4f4d\u4e8e\u65b0\u6cfd\u897f\u5ddePrinceton\uff09\u7684Ib\u671f\u8bd5\u9a8c\u4e2d\uff0c17\u540d\u5165\u7ec4\u7684mCRPC\u60a3\u8005\u4e2d\u6ca1\u6709\u4e00\u4f8b\u663e\u793a\u51fa\u5ba2\u89c2\u53cd\u5e94\uff0c\u4e14\u5176\u4e2d\u4e24\u4e2a\u80bf\u7624\u6837\u672c\u5747\u4e3aPD-L1\u9634\u6027\u3002\u8fd9\u5e76\u4e0d\u4ee4\u4eba\u610f\u5916\uff0c\u56e0\u4e3a\u524d\u5217\u817a\u764c\u901a\u5e38\u8868\u73b0\u4e3a\u4f4e\u6c34\u5e73\u708e\u75c7 (Fig 35.2<\/span>)\u3001PD-L1\u8868\u8fbe\u4e0d\u8db3\u4ee5\u53ca\u4f4e\u7a81\u53d8\u8d1f\u8377\uff0c\u8fd9\u4e9b\u7279\u5f81\u53ef\u80fd\u5171\u540c\u4f7f\u524d\u5217\u817a\u764c\u96be\u4ee5\u6210\u4e3a\u514d\u75ab\u7597\u6cd5\u7684\u6709\u6548\u9776\u70b9\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e0ePD-1\u7c7b\u4f3c\uff0cCTLA-4\u662f\u53e6\u4e00\u79cd\u5728T\u7ec6\u80de\u6fc0\u6d3b\u540e\u8868\u8fbe\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u5206\u5b50\uff0c\u8d1f\u8d23\u6291\u5236T\u7ec6\u80de\u7684\u589e\u6b96\u548c\u6d3b\u6027\u3002CTLA-4\u4e0e\u5176\u914d\u4f53CD80\/B7-1\u548cCD86\/B7-2\u7684\u7ed3\u5408\u4eb2\u548c\u529b\u9ad8\u4e8eT\u7ec6\u80de\u7684\u5171\u523a\u6fc0\u5206\u5b50CD28 (Fig 35.3<\/span>)\uff0c\u56e0\u6b64\u80fd\u591f\u5728\u7ade\u4e89\u4e2d\u80dc\u8fc7CD28\u3002\u8fd9\u79cd\u673a\u5236\u5bf9\u7ef4\u6301\u514d\u75ab\u8010\u53d7\u6027\u81f3\u5173\u91cd\u8981\uff0c\u56e0\u4e3aCTLA-4\u57fa\u56e0\u6572\u9664\u7684\u5c0f\u9f20\u4f1a\u8fc5\u901f\u56e0\u4e25\u91cd\u7684\u6dcb\u5df4\u7ec6\u80de\u708e\u75c7\u800c\u6b7b\u4ea1\u3002\u7136\u800c\uff0cCTLA-4\u5728\u80bf\u7624\u7684\u514d\u75ab\u9003\u9038\u8fc7\u7a0b\u4e2d\u4e5f\u8d77\u5230\u4e86\u5173\u952e\u4f5c\u7528\u3002\u65e9\u671f\u7814\u7a76\u53d1\u73b0\uff0c\u4f7f\u7528\u6297CTLA-4\u6cbb\u7597\u7684\u8377\u7624\u5c0f\u9f20\u8868\u73b0\u51fa\u663e\u8457\u7684\u6297\u80bf\u7624\u6548\u679c\u3002<\/p>\n

\u9488\u5bf9\u665a\u671f\u9ed1\u8272\u7d20\u7624\u7684\u4e24\u9879\u72ec\u7acb\u4e34\u5e8a\u8bd5\u9a8c\u4e5f\u53d6\u5f97\u4e86\u79ef\u6781\u7684\u7ed3\u679c\uff0c\u60a3\u8005\u7684\u4e2d\u4f4d\u603b\u751f\u5b58\u671f\u5f97\u5230\u4e86\u5ef6\u957f\u3002\u6709\u8da3\u7684\u662f\uff0c\u6700\u65b0\u6570\u636e\u8868\u660e\uff0cCTLA-4\u5728\u80bf\u7624\u6d78\u6da6\u6027\u8c03\u8282\u6027T\u7ec6\u80de\uff08Treg\uff09\u4e0a\u7684\u8868\u8fbe\u53ef\u80fd\u9ad8\u4e8e\u5728CD8 T\u7ec6\u80de\u4e0a\u7684\u8868\u8fbe\uff0c\u8fd9\u63d0\u793aCTLA-4\u963b\u65ad\u53ef\u80fd\u901a\u8fc7\u6291\u5236Treg\u7684\u529f\u80fd\u6765\u53d1\u6325\u5176\u6297\u80bf\u7624\u4f5c\u7528\uff0c\u800cTreg\u901a\u5e38\u5728\u6291\u5236T\u7ec6\u80de\u53cd\u5e94\u4e2d\u626e\u6f14\u91cd\u8981\u89d2\u8272\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Fig 35.3<\/span> \u5c55\u793a\u4e86\u6fc0\u6d3b\u4e0e\u6291\u5236\u8fc7\u7a0b\u5728\u80bf\u7624\u53cd\u5e94\u4e2d\u7684\u7ade\u4e89\u673a\u5236\u3002\u6297\u539f\u63d0\u5448\u7ec6\u80de\u53ef\u4ee5\u6fc0\u6d3bCD8 T\u7ec6\u80de\u5e76\u63d0\u4f9b\u989d\u5916\u7684\u5171\u523a\u6fc0\u4fe1\u53f7\u3002\u7136\u800c\uff0c\u80bf\u7624\u7ec6\u80de\u901a\u8fc7\u4e0a\u8c03\u6291\u5236\u6027\u5206\u5b50\u6765\u6291\u5236CD8 T\u7ec6\u80de\u7684\u6fc0\u6d3b\u548c\u7ec6\u80de\u6bd2\u6027\u53cd\u5e94\u3002\u957f\u671f\u66b4\u9732\u4e8e\u8fd9\u4e9b\u6291\u5236\u6027\u914d\u4f53\u53ef\u80fd\u5bfc\u81f4CD8 T\u7ec6\u80de\u7684\u529f\u80fd\u8017\u7aed\uff0c\u4ece\u800c\u524a\u5f31\u514d\u75ab\u7cfb\u7edf\u7684\u6297\u80bf\u7624\u80fd\u529b\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u8f6c\u79fb\u6027\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\uff08mCRPC\uff09\u7684\u65e9\u671f\u7814\u7a76\u4e2d\uff0c\u6297CTLA-4\u7597\u6cd5\u663e\u793a\u51fa\u4e00\u5b9a\u7684\u6d3b\u6027\uff0c\u7ea610-15%\u7684\u60a3\u8005\u51fa\u73b0\u4e86PSA\u6c34\u5e73\u4e0b\u964d\u548c\u90e8\u5206\u5ba2\u89c2\u53cd\u5e94\u3002\u8fd9\u4e9b\u7ed3\u679c\uff0c\u52a0\u4e4b\u5f53\u65f6\u665a\u671fmCRPC\u60a3\u8005\u53ef\u9009\u62e9\u7684\u6cbb\u7597\u65b9\u6848\u6781\u4e3a\u6709\u9650\uff0c\u4fc3\u4f7f\u7814\u7a76\u4eba\u5458\u5bf9\u6297CTLA-4\u7597\u6548\u8fdb\u884c\u4e86\u66f4\u6df1\u5165\u7684\u7814\u7a76\u3002<\/p>\n

\u4e24\u9879\u5173\u952e\u8bd5\u9a8c\u56e0\u6b64\u5c55\u5f00\u3002\u7b2c\u4e00\u9879\u8bd5\u9a8c\u8bc4\u4f30\u4e86\u5728\u591a\u897f\u4ed6\u8d5b\u5316\u7597\u671f\u95f4\u6216\u4e4b\u540e\u51fa\u73b0\u75be\u75c5\u8fdb\u5c55\u7684\u7537\u6027\u60a3\u8005\u4e2d\uff0c\u4f4e\u5242\u91cf\u653e\u7597\uff08RT\uff09\u8054\u5408\u6297CTLA-4\u7597\u6cd5\u4e0e\u5b89\u6170\u5242\u7684\u6548\u679c\u3002\u867d\u7136\u8be5\u8bd5\u9a8c\u672a\u80fd\u8fbe\u5230\u603b\u4f53\u751f\u5b58\u671f\uff08OS\uff09\u7684\u4e3b\u8981\u7ec8\u70b9\uff0c\u4f46\u6cbb\u7597\u7ec4\u7684\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\uff08PFS\uff09\u7565\u6709\u5ef6\u957f\u3002\u8fd9\u9879\u8bd5\u9a8c\u5728\u524d\u5217\u817a\u764c\u514d\u75ab\u6cbb\u7597\u7814\u7a76\u4e2d\u5177\u6709\u72ec\u7279\u6027\uff0c\u56e0\u4e3a\u5b83\u6ca1\u6709\u6392\u9664\u90a3\u4e9b\u60a3\u6709\u5185\u810f\u8f6c\u79fb\u7684\u7537\u6027\u60a3\u8005\u3002\u8fd9\u4e00\u70b9\u5c24\u4e3a\u91cd\u8981\uff0c\u56e0\u4e3a\u6b64\u7c7b\u60a3\u8005\u7684\u603b\u4f53\u9884\u540e\u901a\u5e38\u8f83\u5dee\u3002\u4e8b\u540e\u5206\u6790\u663e\u793a\uff0c\u60a3\u6709\u5185\u810f\u8f6c\u79fb\u7684\u60a3\u8005\u4f3c\u4e4e\u6ca1\u6709\u4ece\u514d\u75ab\u6cbb\u7597\u4e2d\u83b7\u76ca\uff0c\u800c\u6ca1\u6709\u5185\u810f\u8f6c\u79fb\u7684\u7537\u6027\u63a5\u53d7\u6297CTLA-4\u6cbb\u7597\u7684OS\u6bd4\u5b89\u6170\u5242\u7ec4\u4f4e\u7ea64.1\u4e2a\u6708\uff0814.4\u4e2a\u6708\u5bf910.3\u4e2a\u6708\uff09\u3002\u5982\u524d\u6240\u8ff0\uff0c\u5185\u810f\u8f6c\u79fb\u901a\u5e38\u4e0emCRPC\u8f83\u5dee\u7684\u9884\u540e\u76f8\u5173\uff0c\u5c3d\u7ba1\u50cf\u963f\u6bd4\u7279\u9f99\uff08abiraterone\uff09\u7b49\u4e8c\u7ebf\u6fc0\u7d20\u7597\u6cd5\u5728\u6709\u6216\u65e0\u5185\u810f\u8f6c\u79fb\u7684\u60a3\u8005\u4e2d\u5747\u663e\u793a\u51fa\u7597\u6548\u3002\u8f6c\u79fb\u81f3\u809d\u810f\u7b49\u90e8\u4f4d\u7684\u764c\u7ec6\u80de\u53ef\u80fd\u4f1a\u53d1\u751f\u6297\u51cb\u4ea1\u3001\u8840\u7ba1\u751f\u6210\u548c\u514d\u75ab\u539f\u6027\u7279\u6027\u7684\u6839\u672c\u6027\u6539\u53d8\uff0c\u4f7f\u5176\u5bf9\u514d\u75ab\u6cbb\u7597\u66f4\u5177\u62b5\u6297\u529b\u3002<\/p>\n

\u7b2c\u4e8c\u9879III\u671f\u8bd5\u9a8c\u62db\u52df\u4e86\u5316\u7597\u524d\u7684\u65e9\u671fmCRPC\u60a3\u8005\uff0c\u7279\u522b\u6392\u9664\u4e86\u90a3\u4e9b\u60a3\u6709\u5185\u810f\u8f6c\u79fb\u7684\u60a3\u8005\u3002\u4e0d\u5e78\u7684\u662f\uff0c\u8fd9\u9879\u8bd5\u9a8c\u4e5f\u672a\u80fd\u8fbe\u5230\u5176OS\u7ec8\u70b9\u3002<\/p>\n

\u7efc\u4e0a\u6240\u8ff0\uff0c\u6297PD-1\u7684IB\u671f\u8bd5\u9a8c\u7f3a\u4e4f\u53cd\u5e94\uff0c\u4ee5\u53ca\u4e24\u9879\u6297CTLA-4\u7684III\u671f\u8bd5\u9a8c\u7684\u5931\u8d25\uff0c\u5747\u8868\u660e\u8f6c\u79fb\u6027\u524d\u5217\u817a\u764c\u662f\u4e00\u79cd\u76f8\u5bf9\u975e\u514d\u75ab\u539f\u6027\u7684\u80bf\u7624\u7c7b\u578b\u3002\u672a\u6765\u6216\u8bb8\u9700\u8981\u8054\u5408\u6cbb\u7597\u7b56\u7565\u6216\u5176\u4ed6\u836f\u7269\u6765\u6709\u6548\u5e94\u5bf9\u8fd9\u79cd\u764c\u75c7\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\n

\u6709\u4e24\u9879\u7814\u7a76\u6570\u636e\u8868\u660e\uff0cenzalutamide\u6cbb\u7597\u540e\u8fdb\u5c55\u7684\u665a\u671fmCRPC\u53ef\u80fd\u5177\u6709\u72ec\u7279\u7684\u514d\u75ab\u5b66\u7279\u6027\u3002\u9996\u5148\u662f\u4e00\u4efd\u75c5\u4f8b\u62a5\u544a\uff0c\u63cf\u8ff0\u4e86\u4e00\u540denzalutamide\u6cbb\u7597\u5931\u8d25\u7684\u60a3\u8005\u5728\u63a5\u53d7Sipuleucel-T\u6cbb\u7597\u540e\uff0c\u51fa\u73b0\u4e86\u7f55\u89c1\u7684\u5b8c\u5168\u7f13\u89e3\u3002\u66f4\u4e3a\u91cd\u8981\u7684\u662f\uff0c\u8fd1\u671f\u7684\u7814\u7a76\u663e\u793a\uff0cenzalutamide\u8010\u836f\u7684\u524d\u5217\u817a\u764c\u7ec6\u80de\u7cfb\u4f3c\u4e4e\u4e0a\u8c03\u4e86PD-L1\u7684\u8868\u8fbe\uff0c\u8fd9\u63d0\u793aenzalutamide\u8010\u836f\u7684\u524d\u5217\u817a\u764c\u60a3\u8005\u53ef\u80fd\u5bf9PD-1\/PD-L1\u963b\u65ad\u7597\u6cd5\u4ea7\u751f\u53cd\u5e94\u3002<\/p>\n

\u57fa\u4e8e\u8fd9\u4e9b\u53d1\u73b0\uff0cGraff\u7b49\u4eba\u542f\u52a8\u4e86\u4e00\u9879\u6709\u8da3\u7684\u4e34\u5e8a\u8bd5\u9a8c\uff08NCT02312557\uff09\uff0c\u5728\u8fd9\u9879\u8bd5\u9a8c\u4e2d\uff0c\u6700\u521d\u5bf9enzalutamide\u6709\u53cd\u5e94\u5e76\u968f\u540e\u8fdb\u5c55\u7684mCRPC\u60a3\u8005\uff0c\u901a\u8fc7\u5728\u7ee7\u7eed\u4f7f\u7528enzalutamide\u7684\u540c\u65f6\uff0c\u6dfb\u52a0\u6297PD-1\u6297\u4f53pembrolizumab\u8fdb\u884c\u6cbb\u7597\u3002\u8be5\u8bd5\u9a8c\u7684\u7ed3\u679c\u4e4b\u4e00\u5305\u62ec\u4e00\u540d\u60a3\u8005\u7684\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\u957f\u8fbe55\u5468\uff0c\u764c\u75c7\u76f8\u5173\u75bc\u75db\u5f97\u5230\u7f13\u89e3\uff0c\u8840\u6e05PSA\u6c34\u5e73\u964d\u81f3<0.1 ng\/mL\u3002\u6709\u8da3\u7684\u662f\uff0c\u8fd9\u4e9b\u5e94\u7b54\u8005\u4e2d\u6709\u4e00\u540d\u60a3\u8005\u60a3\u6709\u5fae\u536b\u661f\u4e0d\u7a33\u5b9a\u6027\uff08MSI\uff09\u9633\u6027\u75be\u75c5\uff0c\u8fd9\u901a\u5e38\u8868\u660e\u5b58\u5728DNA\u9519\u914d\u4fee\u590d\uff08MMR\uff09\u7f3a\u9677\u3002\u5148\u524d\u7684\u7814\u7a76\u8868\u660e\uff0cPD-1\u963b\u65ad\u5242\u5728MMR\u7f3a\u9677\u60a3\u8005\u4e2d\u5177\u6709\u5e7f\u6cdb\u7684\u6d3b\u6027\uff0c\u8fd9\u53ef\u80fd\u662f\u7531\u4e8e\u65b0\u6297\u539f\u8868\u8fbe\u7684\u589e\u52a0\uff0c\u6210\u4e3a\u66f4\u5e7f\u6cdb\u7684\u6dcb\u5df4\u7ec6\u80de\u5e93\u7684\u9776\u6807\u3002<\/p>\n

\u5c3d\u7ba1\u524d\u5217\u817a\u764c\u4e2dMMR\u7f3a\u9677\u7684\u53d1\u751f\u7387\u76f8\u5bf9\u8f83\u4f4e\uff0c\u4f46\u4e00\u9879\u7814\u7a76\u53d1\u73b0\uff0c\u5728\u665a\u671f\u524d\u5217\u817a\u764c\u768460\u4f8b\u60a3\u8005\u4e2d\uff0c\u67097\u4f8b\u5b58\u5728MMR\u7f3a\u9677\u548c\u5fae\u536b\u661f\u4e0d\u7a33\u5b9a\u6027\u7684\u80bf\u7624\u3002\u7279\u522b\u662f\uff0cMSH2\u548cMSH6\u8fd9\u4e24\u4e2aDNA\u4fee\u590d\u57fa\u56e0\u7684\u7a81\u53d8\u8f83\u4e3a\u5e38\u89c1\uff0c\u53ef\u80fd\u662f\u7531\u96c4\u6fc0\u7d20\u53d7\u4f53\u57fa\u56e0\u91cd\u6392\u5f15\u8d77\u7684\u3002<\/p>\n

\u672a\u6765\u7684\u4e34\u5e8a\u8bd5\u9a8c\u548c\u6cbb\u7597\u7b56\u7565\u5c06\u8d8a\u6765\u8d8a\u591a\u5730\u8003\u8651\u60a3\u8005\u80bf\u7624\u7684\u7a81\u53d8\u72b6\u6001\u548c\u6027\u8d28\uff0c\u8fd9\u53ef\u80fd\u6210\u4e3a\u57fa\u4e8ePD-1\/PD-L1\u963b\u65ad\u7684\u514d\u75ab\u7597\u6cd5\u7684\u9884\u6d4b\u6027\u751f\u7269\u6807\u5fd7\u7269\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\u6709\u591a\u9879\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684II\u671f\u548cIII\u671f\u4e34\u5e8a\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c\u4e2d\uff0c\u6d89\u53ca\u5355\u836f\u6cbb\u7597\u6216\u8054\u5408\u6cbb\u7597 (Table 35.1<\/span>)\u3002\u5176\u4e2d\u4e00\u9879\u7279\u522b\u503c\u5f97\u5173\u6ce8\u7684\u8bd5\u9a8c\u662f\u6297PD-L1\u6297\u4f53atezolizumab\uff08Genentech\u516c\u53f8\uff0c\u4f4d\u4e8e\u52a0\u5229\u798f\u5c3c\u4e9a\u5dde\u65e7\u91d1\u5c71\uff09\u7684III\u671f\u8bd5\u9a8c\u3002\u5728\u8fd9\u9879\u8bd5\u9a8c\u4e2d\uff0c\u9488\u5bf9\u4e00\u7ebfabiraterone acetate\u6cbb\u7597\u5931\u8d25\u7684\u7537\u6027\u60a3\u8005\uff0c\u5c06\u63091:1\u7684\u6bd4\u4f8b\u968f\u673a\u5206\u914d\u63a5\u53d7\u7b2c\u4e8c\u4ee3\u6297\u96c4\u6fc0\u7d20enzalutamide\u5355\u836f\u6cbb\u7597\u6216\u4e0eatezolizumab\u8054\u5408\u6cbb\u7597\u3002\u8be5\u8bd5\u9a8c\u7684\u4e3b\u8981\u7ec8\u70b9\u662f\u603b\u4f53\u751f\u5b58\u671f\u3002<\/p>\n

\u53e6\u4e00\u9879\u503c\u5f97\u6ce8\u610f\u7684\u8bd5\u9a8c\u662f\u5728\u5148\u524d\u63a5\u53d7\u8fc7\u5316\u7597\u7684mCRPC\u60a3\u8005\u4e2d\u5f00\u5c55\u7684II\u671f\u5355\u836f\u8bd5\u9a8c\uff0c\u4f7f\u7528\u6297PD-1\u836f\u7269pembrolizumab\uff0c\u4e3b\u8981\u8bc4\u4f30\u5b89\u5168\u6027\u548c\u5ba2\u89c2\u53cd\u5e94\u7387 (Table 35.1<\/span>)\u3002\u6b64\u5916\uff0c\u4f5c\u4e3a\u4e00\u79cd\u66f4\u5177\u63a2\u7d22\u6027\u7684\u6cbb\u7597\u65b9\u6cd5\uff0c\u76ee\u524d\u6b63\u5728\u8fdb\u884c\u4e00\u9879II\u671f\u8bd5\u9a8c\uff0c\u7ed3\u5408\u6297PD-1\u836f\u7269pembrolizumab\u4e0e\u51b7\u51bb\u624b\u672f\uff0c\u4ee5\u671f\u901a\u8fc7\u91ca\u653e\u80bf\u7624\u6297\u539f\u5e76\u6fc0\u6d3b\u66f4\u591a\u7684CD8+ T\u7ec6\u80de\u6765\u589e\u5f3a\u6297\u80bf\u7624\u53cd\u5e94 (Table 35.1<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u5982\u524d\u6240\u8ff0\uff0c\u6700\u8fd1\u7684\u7814\u7a76\u8868\u660ePD-1\u548cCTLA-4\u53ef\u80fd\u5728\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u7684\u4e0d\u540c\u7ec6\u80de\u7c7b\u578b\u4e0a\u8868\u8fbe\uff0c\u5176\u4e2dCTLA-4\u4e3b\u8981\u5728\u8c03\u8282\u6027T\u7ec6\u80de\uff08Tregs\uff09\u4e0a\u9ad8\u8868\u8fbe\uff0c\u800cPD-1\u5219\u4e3b\u8981\u5728CD8 T\u7ec6\u80de\u4e0a\u8868\u8fbe\u3002\u963b\u65adCTLA-4\u53ef\u4ee5\u6291\u5236\u80bf\u7624\u6d78\u6da6\u6027Tregs\u7684\u6291\u5236\u529f\u80fd\uff0c\u800c\u963b\u65adPD-1\u4e0d\u4ec5\u53ef\u4ee5\u589e\u5f3aCD8 T\u7ec6\u80de\u7684\u529f\u80fd\uff0c\u8fd8\u80fd\u9632\u6b62\u6297\u539f\u8bc6\u522b\u8fc7\u7a0b\u4e2d\u8bf1\u53d1\u7684\u514d\u75ab\u8010\u53d7\u3002\u8fd9\u4e9b\u53d1\u73b0\u652f\u6301\u4e86\u8054\u5408\u963b\u65adPD-1\u548cCTLA-4\u5728\u80bf\u7624\u73af\u5883\u4e2d\u5177\u6709\u534f\u540c\u6548\u5e94\u7684\u6982\u5ff5\uff0c\u7c7b\u4f3c\u4e8e\u52a8\u7269\u6a21\u578b\u4e2d\u89c2\u5bdf\u5230\u7684\u6548\u679c\u3002<\/p>\n

\u8054\u5408PD-1\u548cCTLA-4\u963b\u65ad\u7597\u6cd5\u7684\u4e34\u5e8a\u6570\u636e\u6700\u65e9\u5728\u665a\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u4e2d\u62a5\u544a\uff0c65%\u7684\u60a3\u8005\u663e\u793a\u51fa\u4e34\u5e8a\u6d3b\u6027\u8bc1\u636e\uff0c\u5305\u62ec\u4e00\u4e9b\u5728\u6cbb\u7597\u524d8\u5468\u5185\u8fc5\u901f\u51fa\u73b0\u7684\u53cd\u5e94\u3002\u8be5\u7ec4\u5408\u7597\u6cd5\u6700\u7ec8\u88ab\u7f8e\u56fdFDA\u6279\u51c6\u7528\u4e8e\u9ed1\u8272\u7d20\u7624\u6cbb\u7597\uff0c\u5e76\u4e14\u76ee\u524d\u6b63\u5728\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u548c\u80be\u764c\u7684\u4e00\u7ebf\u6cbb\u7597\u4e2d\u8fdb\u884c\u8bc4\u4f30\u3002\u6709\u8da3\u7684\u662f\uff0c\u9ed1\u8272\u7d20\u7624\u7684III\u671f\u8bd5\u9a8c\u663e\u793a\uff0c\u5373\u4f7f\u5728PD-L1\u9634\u6027\u80bf\u7624\u60a3\u8005\u4e2d\uff0c\u8054\u5408\u7597\u6cd5\u4e5f\u80fd\u4ea7\u751f\u6548\u679c\uff0c\u8fd9\u4e00\u53d1\u73b0\u5bf9\u4e8e\u901a\u5e38PD-L1\u8868\u8fbe\u8f83\u4f4e\u7684\u524d\u5217\u817a\u764c\u5c24\u5176\u5177\u6709\u5438\u5f15\u529b\u3002<\/p>\n

\u57fa\u4e8e\u8fd9\u4e9b\u4ee4\u4eba\u9f13\u821e\u7684\u7ed3\u679c\uff0c\u970d\u666e\u91d1\u65af\u5927\u5b66\u7684\u7814\u7a76\u56e2\u961f\u6700\u8fd1\u5b8c\u6210\u4e86\u4e00\u9879\u9488\u5bf9mCRPC\u60a3\u8005\u7684\u8054\u5408\u6cbb\u7597\u5c0f\u89c4\u6a21\u7814\u7a76\u7684\u62db\u52df\uff0c\u8fd9\u4e9b\u60a3\u8005\u88ab\u9009\u4e2d\u662f\u56e0\u4e3a\u4ed6\u4eec\u5bf9\u6297\u96c4\u6fc0\u7d20\u836f\u7269\u8868\u73b0\u51fa\u8010\u836f\u6027 (Table 35.1<\/span>)\u3002\u8be5\u8bd5\u9a8c\u7684\u4e3b\u8981\u7ec8\u70b9\u662f\u8bc4\u4f30\u6cbb\u7597\u7684\u5b89\u5168\u6027\u3001\u8010\u53d7\u6027\u4ee5\u53ca\u5ba2\u89c2\u53cd\u5e94\u7387\u3002<\/p>\n

\u6b64\u5916\uff0c\u68c0\u67e5\u70b9\u6291\u5236\u5242\u8fd8\u53ef\u4ee5\u4e0e\u975e\u514d\u75ab\u836f\u7269\u8054\u5408\u4f7f\u7528\u3002\u4f8b\u5982\uff0c\u4e00\u4e9b\u524d\u5217\u817a\u80bf\u7624\uff0c\u5c24\u5176\u662f\u90a3\u4e9b\u643a\u5e26BRCA1\/BRCA2\u7a81\u53d8\u7684\u80bf\u7624\uff0c\u5bf9\u591a\u805aADP\u6838\u7cd6\u805a\u5408\u9176\uff08PARP\uff09\u8868\u73b0\u51fa\u4f9d\u8d56\u6027\u3002\u76ee\u524d\u6b63\u5728\u8fdb\u884cI\u671f\u7814\u7a76\uff0c\u4ee5\u8bc4\u4f30\u6297PD-L1\u6297\u4f53durvalumab\uff08MedImmune\u516c\u53f8\uff0c\u4f4d\u4e8e\u9a6c\u91cc\u5170\u5dde\u76d6\u745f\u65af\u5821\uff09\u4e0ePARP\u6291\u5236\u5242olaparib\uff08\u963f\u65af\u5229\u5eb7\u516c\u53f8\uff0c\u4f4d\u4e8e\u7279\u62c9\u534e\u5dde\u5a01\u5c14\u660e\u987f\uff09\u8054\u5408\u6cbb\u7597\u7684\u6548\u679c (Table 35.1<\/span>)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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


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

\n
\n

Table 35.1<\/span> \u524d\u5217\u817a\u764c\u7684\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u4e34\u5e8a\u8bd5\u9a8c<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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


<\/p>\n

\u2014 THE  END \u2014<\/span><\/p>\n


<\/p>\n

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

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

\u521d\u7a3f\u7ffb\u8bd1 | \u7ae0\u9707<\/span><\/p>\n

\u56fe\u6587\u6392\u7248 | \u6797\u5b50\u7545 \u90d1\u5bb6\u6021<\/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

<\/span>
<\/p>\n

\u2589  \u5f80\u671f\u63a8\u9001\u5408\u8f91<\/strong><\/strong><\/section>\n
\n
\n
\n
\n
<\/strong><\/strong><\/section>\n<\/section>\n<\/section>\n
\n
\n
\n
\n
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\n
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\n
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\n

\u80bf\u7624\u514d\u75ab\u5b66\u6700\u65b0\u6587\u732e<\/span><\/a>
<\/p>\n

\u53ef\u4ee5\u67e5\u8be22024\u5e74\u6700\u65b0SCI\u671f\u520a\u5f71\u54cd\u56e0\u5b50\u53ca\u5206\u533a\u5566\uff01<\/a>
\u514d\u75ab\u5b66\u62fe\u9057\u7cfb\u5217<\/a><\/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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<\/p>\n

<\/span><\/p>\n

\u5173\u6ce8\u672c\u53f7~<\/span>
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<\/p>\n

<\/p>\n

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

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