免疫治療在鼻咽癌中的應用

編譯：腫瘤資訊來源：腫瘤資訊專家介紹

Edwin P Hui教授

威爾士親王醫院 臨床腫瘤科

香港中文大學

香港醫學專科學院院士

正如英國著名劇作家喬治.蕭伯納所言「刺激吞噬細胞乃治療萬病之根本」，免疫在腫瘤治療中發揮著越來越重要的角色。以鼻咽癌為例，EB病毒在鼻咽癌細胞中持續存在，因此可以利用T細胞免疫系統通過識別病毒表達的抗原（如EBNA1、LMP1、LMP2等），從而識別出腫瘤細胞。Dr. Edwin的這次報告將展示目前在臨床上進行的免疫療法相關研究，包括過繼性EBV特異性T細胞療法、EBV疫苗以及免疫檢查點抑製劑。首先介紹過繼性EBV特異性療法，它可繞開抗原提呈途徑，直接激活自體細胞毒性T淋巴細胞，從而直接殺死腫瘤細胞。該項研究正在進行3期臨床試驗。其次，通過接種EBV疫苗（如將EBNA-1和LMP2嵌合基因插入改良安卡拉痘病毒構建而成），可提高接種者免疫系統識別腫瘤抗原能力。此外，幾個正在進行的臨床試驗證實免疫檢查點抑製劑具有良好的應用前景。未來，聯合免疫及腫瘤學，無疑會進一步提高癌症患者的生存。

英文原文

The Emerging Role Of Immunotherapy In

Nasopharyngeal Carcinoma (NPC)

Edwin P Hui

Department of Clinical Oncology, Prince of Wales Hospital

The Chinese University of Hong Kong

As the saying by George Bernard Shaw goes 「There is at bottom only one genuinely scientific treatment for all diseases, and that is to stimulate the phagocytes」, immunotherapy has since occupied a position in treating cancer. Take nasopharyngeal carcinoma (NPC) as an example, the consistent presence of Epstein Barr Virus (EBV) in the tumor cells opens up the possibility of an immunotherapeutic approach, exploiting the potential of the immune T-cell system to recognize tumor cells through their expression of viral antigens (EBNA1, LMP1 and LMP2). This presentation will provide an overview on the approaches that are being investigated in the clinic. The first approach is adoptive EBV-specific T-cell therapy, which directly activates autologous cytotoxic T lymphocyte (CTL) to kill cancer cells. This approach is being tested in an ongoing phase 3 clinical trial. A second approach is therapeutic EBV vaccines, for example by inserting EBNA1-LMP2 chimeric gene into Modified Vaccinia Ankara in the MVA-EL vaccine. Therapeutic EBV vaccine has demonstrated improved tumor antigen recognition by the host immune system. Finally, several ongoing clinical trials of immune check point inhibition have reported promising result. In the future, combination immune-oncology is posted to improve the overall survival of cancer patients.

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