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36.2 \u5375\u5de2\u764c\u7684\u80bf\u7624\u514d\u75ab\u6cbb\u7597\u6311\u6218<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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36.2.1 \u589e\u5f3a\u80bf\u7624\u6297\u539f\u8bc6\u522b\u7684\u6cbb\u7597\u65b9\u6cd5<\/p>\n<\/section>\n

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36.2.1.1 \u75ab\u82d7<\/p>\n<\/section>\n

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\u9488\u5bf9\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u4e2d\u8868\u8fbe\u7684\u72ec\u7279\u7ec4\u7ec7\u5206\u5316\u6297\u539f\u7684\u7814\u7a76\uff0c\u63a8\u52a8\u4e86\u591a\u79cd\u75ab\u82d7\u63a5\u79cd\u65b9\u6cd5\u7684\u53d1\u5c55\u3002\u8fd9\u4e9b\u65b9\u6cd5\u5305\u62ec\u7531\u7279\u5b9a\u80bd\u548c\u86cb\u767d\u8d28\u7ec4\u6210\u7684\u7b80\u5355\u75ab\u82d7\u5236\u5242\uff0c\u4ee5\u53ca\u66f4\u4e3a\u590d\u6742\u7684\u7b56\u7565\uff0c\u5982\u5de5\u7a0b\u5316\u7ec6\u80de\u75ab\u82d7\u3001\u6811\u7a81\u72b6\u7ec6\u80de\uff08DC\uff09\u75ab\u82d7\u3001\u75c5\u6bd2\u8f7d\u4f53\u75ab\u82d7\u548c\u6eb6\u7624\u75c5\u6bd2\u3002\u5927\u591a\u6570\u7814\u7a76\u96c6\u4e2d\u4e8e\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u4e2d\u5df2\u77e5\u7684\u764c\u777e\u4e38\u6297\u539f\uff08\u5982NY-ESO-1\uff09\u548c\u86cb\u767d\u8d28\uff08\u5982p53\u3001survivin\u3001HER-2\u548cMUC1\uff09\u7684\u8fc7\u8868\u8fbe\u3002\u4f8b\u5982\uff0c\u6709\u7814\u7a76\u663e\u793a43%\u7684\u665a\u671f\u5375\u5de2\u764c\u60a3\u8005\u8868\u8fbeNY-ESO-1\u3002<\/p>\n

2014\u5e74\u53d1\u8868\u7684\u4e00\u9879II\u671f\u7814\u7a76\u8bc4\u4f30\u4e8622\u4f8b\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\uff0882%\u4e3a\u6d46\u6db2\u6027\u7ec4\u7ec7\u5b66\u7c7b\u578b\u4e14NY-ESO-1\u9633\u6027\uff09\u5728\u6807\u51c6\u6cbb\u7597\uff08\u51cf\u8102\u624b\u672f\u548c\u94c2\u57fa\u5316\u7597\uff09\u540e\u63a5\u79cdHLA-A*0201\u9650\u5236\u6027NY-ESO-1b\u80bd\u7684\u6548\u679c\u3002\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u4e2d\u4f4d\u603b\u751f\u5b58\u671f\u4e3a48\u4e2a\u6708\uff0c\u4e2d\u4f4d\u75be\u75c5\u8fdb\u5c55\u65f6\u95f4\u4e3a21\u4e2a\u6708\uff0895% CI, 16-29\u4e2a\u6708\uff09\u3002<\/p>\n

\u867d\u7136\u8bb8\u591a\u7814\u7a76\u5df2\u8bc1\u660e\u8fd9\u4e9b\u75ab\u82d7\u7b56\u7565\u80fd\u591f\u8bf1\u5bfc\u514d\u75ab\u5e94\u7b54\uff0c\u4f46\u5f88\u5c11\u6709\u7814\u7a76\u663e\u793a\u5176\u663e\u8457\u7684\u4e34\u5e8a\u76ca\u5904\u3002\u8fd9\u53ef\u80fd\u662f\u56e0\u4e3a\u8fd9\u4e9b\u7b56\u7565\u5c1a\u4e0d\u8db3\u4ee5\u514b\u670d\u5bf9\u81ea\u8eab\u6297\u539f\u7684\u514d\u75ab\u8010\u53d7\uff0c\u5e76\u6709\u6548\u6fc0\u6d3b\u6297\u539f\u7279\u5f02\u6027T\u7ec6\u80de\u3002\u7136\u800c\uff0c\u5c3d\u7ba1\u5982\u6b64\uff0c\u8fd9\u4e9b\u65b9\u6cd5\u5728\u4e0e\u5176\u4ed6\u7597\u6cd5\u8054\u5408\u4f7f\u7528\u65f6\uff0c\u53ef\u80fd\u4ecd\u5177\u6709\u6f5c\u5728\u7684\u4ef7\u503c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.2.1.2 \u5148\u5929\u514d\u75ab\u6fc0\u6d3b\u5242<\/p>\n<\/section>\n

\n
\n
\n

\u901a\u8fc7\u6297\u539f\u5448\u9012\u7ec6\u80de\uff08APCs\uff09\u589e\u5f3a\u80bf\u7624\u6297\u539f\u5448\u9012\u7684\u53e6\u4e00\u79cd\u7b56\u7565\u662f\u5229\u7528\u9776\u5411\u5148\u5929\u514d\u75ab\u5e94\u7b54\u7684\u836f\u7269\u3002APCs\u7684\u6297\u539f\u52a0\u5de5\u548c\u5448\u9012\u8fc7\u7a0b\u9700\u8981\u6fc0\u6d3b\u4fe1\u53f7\uff0c\u8fd9\u4e00\u4fe1\u53f7\u53ef\u4ee5\u901a\u8fc7\u6fc0\u6d3b\u6a21\u5f0f\u8bc6\u522b\u53d7\u4f53\uff08PRRs\uff09\u5982Toll\u6837\u53d7\u4f53\uff08TLRs\uff09\u6765\u5b9e\u73b0\u3002TLRs\u80fd\u591f\u8bc6\u522b\u591a\u79cd\u75c5\u539f\u4f53\u7684\u5171\u6709\u7279\u5f81\u5206\u5b50\uff0c\u8fd8\u80fd\u611f\u77e5\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u7684\u201c\u5371\u9669\u4fe1\u53f7\u201d\uff0c\u8fd9\u4e9b\u4fe1\u53f7\u7531\u51cb\u4ea1\u7ec6\u80de\u91ca\u653e\u7684\u5185\u6e90\u6027\u5206\u5b50\u6784\u6210\u3002<\/p>\n

TLR8\u7684\u5c0f\u5206\u5b50\u6fc0\u52a8\u5242VTX2337 (motolimod)\u4e0e\u963f\u9709\u7d20\u8102\u8d28\u4f53\u8054\u5408\u4f7f\u7528\u5728\u665a\u671f\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u4e2d\u7684I\u671f\u7814\u7a76\u663e\u793a\u4e86\u826f\u597d\u7684\u5b89\u5168\u6027\u3001\u514d\u75ab\u6fc0\u6d3b\u6548\u679c\u548c\u4e34\u5e8a\u83b7\u76ca\u3002\u76ee\u524d\uff0c\u4e00\u4e9bII\u671f\u7814\u7a76\u6b63\u5728\u8bc4\u4f30motolimod\u4e0e\u5176\u4ed6\u514d\u75ab\u7597\u6cd5\u6216\u8102\u8d28\u5316\u963f\u9709\u7d20\u7684\u8054\u5408\u6548\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u6d3b\u5316\u7684APCs\u4f1a\u4ea7\u751fI\u578b\u5e72\u6270\u7d20\uff08IFN\uff09\uff0c\u8fd9\u5728\u6297\u75c5\u6bd2\u514d\u75ab\u5e94\u7b54\u4e2d\u53d1\u6325\u91cd\u8981\u4f5c\u7528\uff0c\u540c\u65f6\u4e5f\u662fAPCs\u5448\u9012\u80bf\u7624\u6297\u539f\u7684\u5fc5\u8981\u6761\u4ef6\u3002\u5c3d\u7ba1I\u578bIFN\u5df2\u5728\u591a\u79cd\u764c\u75c7\u7c7b\u578b\u4e2d\u8fdb\u884c\u4e86\u8bc4\u4f30\uff0c\u5e76\u88ab\u6279\u51c6\u7528\u4e8e\u5207\u9664\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u8f85\u52a9\u6cbb\u7597\uff0c\u4f46Alberts\u7b49\u4eba\u7684\u7814\u7a76\u663e\u793a\uff0c\u5168\u8eab\u6216\u8179\u8154\u7ed9\u836fIFN\u03b1\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u4e2d\u7684\u7597\u6548\u6709\u9650\uff0c\u5e76\u4e14\u4f34\u6709\u8f83\u9ad8\u7684\u6bd2\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
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\n

\u6eb6\u7624\u75c5\u6bd2\u56e0\u5176\u7279\u6027\u80fd\u591f\u9009\u62e9\u6027\u5730\u5728\u764c\u7ec6\u80de\u4e2d\u590d\u5236\uff0c\u800c\u4e0d\u5f71\u54cd\u6b63\u5e38\u7ec4\u7ec7\u3002\u9664\u4e86\u4f5c\u4e3a\u80bf\u7624\u6d88\u878d\u5242\uff0c\u6eb6\u7624\u75c5\u6bd2\u8fd8\u901a\u8fc7\u91ca\u653e\u80bf\u7624\u6297\u539f\u3001PRR\u914d\u4f53\u548c\u5371\u9669\u4fe1\u53f7\uff0c\u53ca\u4ea7\u751fI\u578bIFN\uff0c\u4ece\u591a\u4e2a\u5c42\u9762\u6fc0\u6d3b\u5148\u5929\u514d\u75ab\u53cd\u5e94\u3002\u51e0\u9879\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u4e2d\u4f7f\u7528\u6eb6\u7624\u75c5\u6bd2\u7684\u4e34\u5e8a\u8bd5\u9a8c\u663e\u793a\uff0c\u6eb6\u7624\u75c5\u6bd2\u5728\u90e8\u5206\u60a3\u8005\u4e2d\u5177\u6709\u826f\u597d\u7684\u5b89\u5168\u6027\u548c\u6301\u4e45\u7684\u4e34\u5e8a\u76ca\u5904\u3002<\/p>\n

\u603b\u7684\u6765\u8bf4\uff0c\u901a\u8fc7\u5148\u5929\u514d\u75ab\u7cfb\u7edf\u589e\u5f3a\u80bf\u7624\u6297\u539f\u5448\u9012\u7684\u7b56\u7565\u5df2\u88ab\u8bc1\u660e\u662f\u5b89\u5168\u7684\uff0c\u4f46\u76ee\u524d\u5176\u7597\u6548\u4ecd\u6709\u9650\u3002\u672a\u6765\uff0c\u53ef\u80fd\u9700\u8981\u901a\u8fc7\u8054\u5408\u6cbb\u7597\u6765\u589e\u5f3a\u8fd9\u4e9b\u836f\u7269\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u4e2d\u7684\u6548\u679c\uff0c\u5373\u7ed3\u5408\u9776\u5411T\u7ec6\u80de\u6d3b\u5316\u548c\u9002\u5e94\u6027\u514d\u75ab\u5e94\u7b54\u7684\u7597\u6cd5\uff0c\u4ee5\u8fdb\u4e00\u6b65\u5f3a\u5316\u7531\u75ab\u82d7\u6216\u5148\u5929\u514d\u75ab\u6fc0\u6d3b\u5242\u8bf1\u5bfc\u7684T\u7ec6\u80de\u5e94\u7b54\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.2.2 \u589e\u5f3aT\u7ec6\u80de\u6d3b\u5316\u7684\u6cbb\u7597\u65b9\u6cd5<\/p>\n<\/section>\n

\n
\n
\n

T\u7ec6\u80de\u7684\u5b58\u6d3b\u3001\u589e\u6b96\u548c\u6d3b\u5316\u53d7\u591a\u79cd\u56e0\u7d20\u7684\u8c03\u63a7\uff0c\u5305\u62ec\u7ec6\u80de\u56e0\u5b50\u4ee5\u53ca\u4e00\u7cfb\u5217\u514d\u75ab\u523a\u6fc0\u548c\u6291\u5236\u53d7\u4f53\u3002\u5df2\u6709\u4e00\u4e9b\u7814\u7a76\u63a2\u7d22\u4e86\u9776\u5411T\u7ec6\u80de\u7684\u836f\u7269\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u514d\u75ab\u6cbb\u7597\u4e2d\u7684\u5e94\u7528\uff0c\u6db5\u76d6\u4e86\u65e8\u5728\u6fc0\u6d3bT\u7ec6\u80de\u7684\u836f\u7269\u4ee5\u53ca\u8fc7\u7ee7\u6027T\u7ec6\u80de\u7597\u6cd5\u7b49\u7b56\u7565\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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36.2.2.1 \u7ec6\u80de\u56e0\u5b50<\/p>\n<\/section>\n

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\n

\u7ec6\u80de\u56e0\u5b50\u767d\u4ecb\u7d20\uff08IL\uff09-2\u548cIL-12\u662f\u6709\u6548\u7684T\u7ec6\u80de\u589e\u6b96\u548c\u7ec6\u80de\u6bd2\u6027\u6fc0\u6d3b\u5242\uff0c\u4f5c\u4e3a\u6297\u764c\u836f\u7269\u7684\u7528\u9014\u5df2\u5728\u591a\u79cd\u764c\u75c7\u7c7b\u578b\u4e2d\u8fdb\u884c\u4e86\u63a2\u7d22\uff0c\u5305\u62ec\u5375\u5de2\u764c\u3002\u7136\u800c\uff0c\u8fd9\u4e9b\u836f\u7269\u7684\u7cfb\u7edf\u6027\u7ed9\u836f\u53d7\u5230\u6bd2\u6027\u7684\u9650\u5236\u3002\u5728\u4e00\u9879\u9488\u5bf9\u6301\u7eed\u6216\u590d\u53d1\u6027\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u7684I\/II\u671f\u7814\u7a76\u4e2d\uff0c\u8179\u8154\u6ce8\u5c04IL-2\u7684\u603b\u4f53\u7f13\u89e3\u7387\u4e3a25.7%\uff0c\u4f46\u8be5\u6cbb\u7597\u65b9\u6848\u4f34\u968f\u7740\u663e\u8457\u7684\u6bd2\u6027\u3002<\/p>\n

\u4e3a\u4e86\u514b\u670d\u8fd9\u4e00\u95ee\u9898\uff0c\u7814\u7a76\u8005\u63a2\u7d22\u4e86\u53e6\u4e00\u79cdIL-12\u7684\u9012\u9001\u7b56\u7565\uff0c\u5373\u4f7f\u7528\u8868\u8fbeIL-12\u7684\u8d28\u7c92\u3002\u5728\u6700\u8fd1\u7684\u4e00\u9879\u7814\u7a76\u4e2d\uff0c22\u4f8b\u590d\u53d1\u6027\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u63a5\u53d7\u4e86\u8179\u8154\u5185\u6ce8\u5c04EGEN-001\uff08\u7531\u8102\u805a\u5408\u7269\u5236\u5907\u7684IL-12\u8d28\u7c92\uff09\uff0c\u7ed3\u679c\u663e\u793a35%\u7684\u60a3\u8005\u75c5\u60c5\u7a33\u5b9a\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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36.2.2.2 \u514d\u75ab\u68c0\u67e5\u70b9<\/p>\n<\/section>\n

\n
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\u5bf9\u8c03\u8282T\u7ec6\u80de\u6d3b\u5316\u7684\u5171\u523a\u6fc0\u548c\u5171\u6291\u5236\u53d7\u4f53\u7684\u8bc6\u522b\uff0c\u63a8\u52a8\u4e86\u9488\u5bf9\u8fd9\u4e9b\u53d7\u4f53\u7684\u6297\u4f53\u7684\u5f00\u53d1\u3002\u7279\u522b\u662f\uff0c\u9776\u5411\u6291\u5236\u6027\u53d7\u4f53\u5982\u7ec6\u80de\u6bd2\u6027T\u6dcb\u5df4\u7ec6\u80de\u76f8\u5173\u6297\u539f4\uff08CTLA-4\uff09\u3001\u7a0b\u5e8f\u6027\u6b7b\u4ea11\uff08PD-1\uff09\u53ca\u5176\u914d\u4f53\uff08PD-L1\uff09\u7684\u6297\u4f53\u5df2\u8fdb\u5165\u4e34\u5e8a\u5f00\u53d1\u7684\u540e\u671f\u9636\u6bb5\u3002\u5176\u4e2d\uff0c\u9776\u5411CTLA-4\u7684\u836f\u7269\u4f0a\u5339\u6728\u5355\u6297\uff08ipilimumab\uff09\u5df2\u88ab\u6279\u51c6\u7528\u4e8e\u8f6c\u79fb\u6027\u9ed1\u8272\u7d20\u7624\uff0c\u9776\u5411PD-1\u7684\u836f\u7269\u7eb3\u6b66\u5229\u5c24\u5355\u6297\uff08nivolumab\uff09\u548c\u5e15\u59c6\u73e0\u5355\u6297\uff08pembrolizumab\uff09\u5219\u5df2\u88ab\u6279\u51c6\u7528\u4e8e\u591a\u79cd\u7c7b\u578b\u7684\u8f6c\u79fb\u6027\u80bf\u7624\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
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\n

\u57fa\u4e8e\u8fd9\u4e9b\u53d1\u73b0\uff0c\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u7597\u6cd5\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u4e2d\u7684\u5e94\u7528\u5f97\u5230\u4e86\u63a2\u7d22\u3002\u867d\u7136CTLA-4\u9776\u5411\u6297\u4f53\u5728\u8f6c\u79fb\u6027\u9ed1\u8272\u7d20\u7624\u4e2d\u663e\u793a\u51fa\u7597\u6548\uff0c\u4f46\u4f5c\u4e3a\u5355\u4e00\u836f\u7269\uff0c\u5176\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u4e2d\u7684\u7597\u6548\u8fc4\u4eca\u4ecd\u7136\u6709\u9650\u3002<\/p>\n

\u5728\u4e00\u9879\u9488\u5bf911\u4f8b\u63a5\u53d7GVAX\uff08\u8868\u8fbe\u7c92\u7ec6\u80de-\u5de8\u566c\u7ec6\u80de\u96c6\u843d\u523a\u6fc0\u56e0\u5b50\u7684\u81ea\u4f53\u80bf\u7624\u7ec6\u80de\u75ab\u82d7\uff09\u6cbb\u7597\u7684\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u7684\u7814\u7a76\u4e2d\uff0c\u4f0a\u5339\u6728\u5355\u6297\u6cbb\u7597\u5bfc\u81f4\u5176\u4e2d1\u4f8b\u60a3\u8005\u83b7\u5f97\u4e86\u8d85\u8fc74\u5e74\u7684\u5ba2\u89c2\u53cd\u5e94\u3002\u7136\u800c\uff0c\u65b0\u7684\u4e34\u5e8a\u6570\u636e\u8868\u660e\uff0c\u9776\u5411PD-1\u548cPD-L1\u53ef\u80fd\u662f\u6cbb\u7597\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u7684\u66f4\u6709\u524d\u666f\u7684\u7b56\u7565\u3002Hamanishi\u53ca\u5176\u540c\u4e8b\u53d1\u8868\u4e86\u4e00\u9879\u5173\u4e8e\u6297PD-1\u6297\u4f53\u7eb3\u6b66\u5229\u5c24\u5355\u6297\u7684II\u671f\u7814\u7a76\uff0c\u7814\u7a76\u5bf9\u8c61\u4e3a20\u4f8b\u7ecf\u8fc7\u91cd\u5ea6\u9884\u5904\u7406\u7684\u665a\u671f\u6297\u94c2\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u3002\u5176\u4e2d75%\u4e3a\u6d46\u6db2\u6027\u764c\uff0c15%\u4e3a\u5b50\u5bab\u5185\u819c\u6837\u764c\uff0c10%\u4e3a\u900f\u660e\u7ec6\u80de\u764c\u3002\u60a3\u8005\u6bcf\u4e24\u5468\u63a5\u53d71\u62163 mg\/kg\u5242\u91cf\u7684\u7eb3\u6b66\u5229\u5c24\u5355\u6297\uff08\u4e24\u4e2a10\u4f8b\u60a3\u8005\u961f\u5217\uff09\uff0c\u6700\u591a\u63a5\u53d76\u4e2a\u5468\u671f\uff08\u6bcf\u4e2a\u5468\u671f4\u6b21\u7ed9\u836f\uff09\u6216\u76f4\u5230\u75be\u75c5\u8fdb\u5c55\u4e3a\u6b62\u3002\u7814\u7a76\u663e\u793a\uff0c8\u4f8b\uff0840%\uff09\u60a3\u8005\u53d1\u751f\u4e863\u7ea7\u62164\u7ea7\u6cbb\u7597\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\u3002\u6700\u4f73\u603b\u7f13\u89e3\u7387\u4e3a15%\uff0c\u5305\u62ec\u4e24\u540d\u57283 mg\/kg\u961f\u5217\u4e2d\u83b7\u5f97\u6301\u4e45\u5b8c\u5168\u7f13\u89e3\u7684\u60a3\u8005\u3002\u75be\u75c5\u63a7\u5236\u7387\u4e3a45%\u3002\u7814\u7a76\u7ed3\u675f\u65f6\uff0c\u4e2d\u4f4d\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\u4e3a3.5\u4e2a\u6708\uff0895% CI, 1.7-3.9\u4e2a\u6708\uff09\uff0c\u4e2d\u4f4d\u603b\u751f\u5b58\u671f\u4e3a20\u4e2a\u6708\uff0895% CI, 7.0\u4e2a\u6708\u81f3\u672a\u8fbe\u5230\uff09\u3002<\/p>\n

\u6b64\u5916\uff0cpd-l1\u6291\u5236\u5242\u963f\u7ef4\u9c81\u5355\u6297\uff08avelumab\uff09\u548c\u5e15\u59c6\u73e0\u5355\u6297\uff08pembrolizumab\uff09\u4e5f\u663e\u793a\u51fa\u76f8\u4f3c\u7684\u6d3b\u6027\uff0c\u7f13\u89e3\u7387\u8303\u56f4\u4e3a11%\u81f317%\uff0c\u75be\u75c5\u63a7\u5236\u7387\u9ad8\u8fbe65%\u3002\u76ee\u524d\uff0c\u8fd9\u4e9b\u836f\u7269\u6b63\u5728\u8fdb\u884c\u66f4\u5927\u89c4\u6a21\u7684\u7814\u7a76\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u5728\u52a8\u7269\u6a21\u578b\u4e2d\uff0c\u8054\u5408\u4f7f\u7528CTLA-4\u548cPD-1\u963b\u65ad\u5242\u663e\u793a\u51fa\u76f8\u52a0\u751a\u81f3\u534f\u540c\u7684\u6297\u80bf\u7624\u6d3b\u6027\u3002\u6700\u8fd1\u7684\u4e00\u9879III\u671f\u7814\u7a76\u8bc4\u4f30\u4e86CTLA-4\u963b\u65ad\u5242\u4f0a\u5339\u6728\u5355\u6297\u4e0ePD-1\u963b\u65ad\u5242\u7eb3\u6b66\u5229\u5c24\u5355\u6297\u8054\u5408\u6cbb\u7597\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u7597\u6548\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u5355\u72ec\u4f7f\u7528\u5176\u4e2d\u4efb\u4f55\u4e00\u79cd\u836f\u7269\u76f8\u6bd4\uff0c\u8054\u5408\u6cbb\u7597\u663e\u8457\u63d0\u9ad8\u4e86\u7f13\u89e3\u7387\u548c\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\u3002\u8fd9\u4e00\u7ed3\u679c\u4fc3\u4f7f\u7f8e\u56fd\u98df\u54c1\u548c\u836f\u7269\u7ba1\u7406\u5c40\uff08FDA\uff09\u6700\u8fd1\u6279\u51c6\u4e86\u8be5\u8054\u5408\u7597\u6cd5\u7528\u4e8e\u6cbb\u7597\u9ed1\u8272\u7d20\u7624\uff0c\u5c3d\u7ba1\u8fd9\u4e00\u65b9\u6848\u786e\u5b9e\u4f34\u968f\u7740\u8f83\u9ad8\u76843\u7ea7\u6bd2\u6027\u53d1\u751f\u7387\u3002\u76ee\u524d\uff0c\u4e00\u9879\u7531NRG\u80bf\u7624\u7ec4\u8fdb\u884c\u7684\u968f\u673aII\u671f\u7814\u7a76\u6b63\u5728\u6bd4\u8f83\u7eb3\u6b66\u5229\u5c24\u5355\u6297\u4e0e\u5e15\u59c6\u73e0\u5355\u6297\u8054\u5408\u6cbb\u7597\u4e0e\u5355\u72ec\u4f7f\u7528\u7eb3\u6b66\u5229\u5c24\u5355\u6297\u7684\u6548\u679c\uff0c\u4ee5\u786e\u5b9a\u8fd9\u79cd\u8054\u5408\u7597\u6cd5\u5728\u590d\u53d1\u6027\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u60a3\u8005\u4e2d\u7684\u7597\u6548\u548c\u5b89\u5168\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.2.2.3 \u8fc7\u7ee7T\u7ec6\u80de\u7597\u6cd5<\/p>\n<\/section>\n

\n
\n
\n

\u8fc7\u7ee7\u6027\u7ec6\u80de\u7597\u6cd5\uff08ACTs\uff09\u4f9d\u8d56\u4e8e\u4ece\u80bf\u7624\u4e2d\u5206\u79bb\u5e76\u5728\u4f53\u5916\u6269\u589e\u5927\u91cf\u81ea\u4f53\u80bf\u7624\u53cd\u5e94\u6027T\u7ec6\u80de\u3002\u65e9\u671f\u7814\u7a76\u62a5\u9053\u4e86ACT\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u4e2d\u7684\u663e\u8457\u7597\u6548\uff0c\u5c3d\u7ba1\u8fd9\u4e9b\u7814\u7a76\u7531\u4e8e\u9009\u62e9\u4e86\u80fd\u591f\u5206\u79bb\u51fa\u8db3\u591f\u6570\u91cfTILs\u7684\u60a3\u8005\uff0c\u53ef\u80fd\u5b58\u5728\u4e00\u5b9a\u7684\u9009\u62e9\u504f\u5dee\u3002<\/p>\n

\u66f4\u591a\u7684\u7814\u7a76\u6b63\u5728\u63a2\u7d22ACT\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u6cbb\u7597\u4e2d\u7684\u5e94\u7528\u3002\u4f5c\u4e3a\u66ff\u4ee3\u7b56\u7565\uff0c\u5de5\u7a0b\u5316T\u7ec6\u80de\u6280\u672f\u65e0\u9700\u5206\u79bbTILs\u3002\u901a\u8fc7\u8fd9\u79cd\u65b9\u6cd5\uff0c\u5916\u5468\u8840\u4e2d\u7684\u81ea\u4f53\u6dcb\u5df4\u7ec6\u80de\u53ef\u4ee5\u88ab\u8f6c\u5bfc\u4ee5\u8868\u8fbe\u7279\u5b9a\u80bf\u7624\u6297\u539f\u7684MHC\u80bd\u8bc6\u522bT\u7ec6\u80de\u53d7\u4f53\u6216\u8bc6\u522b\u80bf\u7624\u76f8\u5173\u8868\u9762\u6297\u539f\u7684\u5d4c\u5408\u6297\u539f\u53d7\u4f53\uff08CAR\uff09\u3002<\/p>\n

\u8fd9\u4e9b\u7b56\u7565\u5728\u4e34\u5e8a\u524d\u7814\u7a76\u4e2d\u663e\u793a\u51fa\u6709\u6548\u6027\uff0c\u5176\u4e2d\u8868\u8fbeMUC16\u7279\u5f02\u6027CAR\u7684\u5de5\u7a0b\u5316T\u7ec6\u80de\u5df2\u88ab\u8bc1\u660e\u80fd\u591f\u5b8c\u5168\u6839\u9664\u539f\u4f4d\u5375\u5de2\u5f02\u79cd\u79fb\u690d\u7269\u3002\u9488\u5bf9\u8fd9\u4e00\u7b56\u7565\u7684I\u671f\u4e34\u5e8a\u7814\u7a76\u76ee\u524d\u6b63\u5728\u5f00\u53d1\u4e2d\u3002<\/p>\n

\u6b64\u5916\uff0c\u9488\u5bf9\u5176\u4ed6\u5375\u5de2\u764c\u76f8\u5173\u86cb\u767d\u5982\u53f6\u9178\u53d7\u4f53\u03b1\u548c\u95f4\u76ae\u7d20\u7684\u8fc7\u7ee7\u6027T\u7ec6\u80de\u8f6c\u79fb\u6280\u672f\uff0c\u5df2\u6709\u591a\u9879I\u671f\u548cII\u671f\u4e34\u5e8a\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c\u4e2d\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.2.3 \u963b\u65ad\u514d\u75ab\u6291\u5236\u5176\u4ed6\u8def\u5f84\u7684\u6cbb\u7597\u7b56\u7565<\/p>\n<\/section>\n

\n
\n
\n

\u5c3d\u7ba1\u65e9\u671f\u7684\u4e34\u5e8a\u6570\u636e\u4ee4\u4eba\u9f13\u821e\uff0c\u4f46\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7597\u6cd5\u5728\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u4e2d\u7684\u7597\u6548\u5e76\u4e0d\u666e\u904d\u3002\u56e0\u6b64\uff0c\u5f00\u53d1\u9884\u6d4b\u6027\u751f\u7269\u6807\u5fd7\u7269\u548c\u8054\u5408\u7597\u6cd5\u663e\u5f97\u5c24\u4e3a\u91cd\u8981\u3002\u4e3a\u4e86\u589e\u5f3a\u7597\u6548\uff0c\u7814\u7a76\u8005\u6b63\u5c1d\u8bd5\u5c06PD-1\u548cPD-L1\u963b\u65ad\u6297\u4f53\u4e0e\u5176\u4ed6\u9776\u5411T\u7ec6\u80de\u6d3b\u5316\u673a\u5236\u7684\u6297\u4f53\uff08\u5982\u7cd6\u76ae\u8d28\u6fc0\u7d20\u8bf1\u5bfc\u7684\u80bf\u7624\u574f\u6b7b\u56e0\u5b50\u53d7\u4f53\u76f8\u5173\u86cb\u767d[GITR]\u3001OX40\u30014-1BB\uff09\u4ee5\u53ca\u5176\u4ed6\u514d\u75ab\u68c0\u67e5\u70b9\u7684\u6297\u4f53\uff08\u5982\u6dcb\u5df4\u7ec6\u80de\u6d3b\u5316\u57fa\u56e0[LAG3]\u548cT\u7ec6\u80de\u514d\u75ab\u7403\u86cb\u767d\u548c\u7c98\u86cb\u767d\u7ed3\u6784\u57df-3 [TIM3]\uff09\u8054\u5408\u4f7f\u7528\u3002\u8fd9\u4e9b\u7b56\u7565\u5df2\u7ecf\u5728\u591a\u79cd\u80bf\u7624\u7c7b\u578b\u4e2d\u8fdb\u5165\u4e34\u5e8a\u8bd5\u9a8c\u3002<\/p>\n

\u6b64\u5916\uff0c\u67d0\u4e9b\u514d\u75ab\u6291\u5236\u673a\u5236\u4e0e\u4e0a\u76ae\u6027\u5375\u5de2\u764c\u7684\u4e0d\u826f\u9884\u540e\u5bc6\u5207\u76f8\u5173\uff0c\u5305\u62ec\u80bf\u7624\u6d78\u6da6\u6027\u8c03\u8282\u6027T\u7ec6\u80de\uff08Tregs\uff09\u3001\u80bf\u7624\u76f8\u5173\u5de8\u566c\u7ec6\u80de\uff08TAMs\uff09\u3001\u9ad3\u6e90\u6027\u6291\u5236\u7ec6\u80de\uff08MDSCs\uff09\u4ee5\u53ca\u7531\u80bf\u7624\u6216\u57fa\u8d28\u7ec6\u80de\u8868\u8fbe\u7684\u5432\u54da\u80fa2,3-\u53cc\u52a0\u6c27\u9176\uff08IDO\uff09\u3002\u56e0\u6b64\uff0c\u8054\u5408\u4f7f\u7528PD-1\/PD-L1\u963b\u65ad\u5242\u548c\u9776\u5411\u8fd9\u4e9b\u514d\u75ab\u6291\u5236\u673a\u5236\u7684\u7597\u6cd5\u5177\u6709\u5408\u7406\u6027\u3002<\/p>\n

\u827e\u5361\u54da\u53f8\u4ed6\uff08Epacadostat\uff09\u662f\u4e00\u79cd\u53e3\u670dIDO1\u6291\u5236\u5242\uff0c\u76ee\u524d\u6b63\u5728\u5bf9\u665a\u671f\u5375\u5de2\u764c\u548c\u4e09\u9634\u6027\u4e73\u817a\u764c\u60a3\u8005\u8fdb\u884cI\/II\u671f\u4e34\u5e8a\u7814\u7a76\uff0c\u8bc4\u4f30\u5176\u5355\u836f\u6cbb\u7597\u6548\u679c\u4ee5\u53ca\u4e0e\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u8054\u5408\u4f7f\u7528\u7684\u7597\u6548\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.2.4 \u5355\u514b\u9686\u6297\u4f53<\/p>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\u5df2\u53d1\u73b0\u51e0\u79cd\u4e0e\u5375\u5de2\u764c\u76f8\u5173\u7684\u6297\u539f\uff0c\u8fd9\u4e9b\u6297\u539f\u53ef\u80fd\u6210\u4e3a\u5355\u514b\u9686\u6297\u4f53\uff08mAbs\uff09\u7684\u6f5c\u5728\u9776\u70b9\u3002\u56e0\u6b64\uff0c\u591a\u4e2a\u5355\u514b\u9686\u6297\u4f53\u6b63\u5728\u4f5c\u4e3a\u8fd9\u4e00\u75be\u75c5\u7684\u65b0\u578b\u6cbb\u7597\u65b9\u6cd5\u8fdb\u884c\u5f00\u53d1\u3002\u5176\u4e2d\uff0c\u9776\u5411CA-125\u3001\u53f6\u9178\u53d7\u4f53\u03b1\u548c\u03b4\u6837\u914d\u4f534\uff08DLL4\uff09\u7684\u5355\u514b\u9686\u6297\u4f53\u6b63\u5728\u4e34\u5e8a\u5f00\u53d1\u4e2d\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n


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

\n
\n

36.3 \u4e73\u817a\u764c\u7684\u80bf\u7624\u514d\u75ab\u6cbb\u7597\u6311\u6218<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u4e73\u817a\u764c\u662f\u5168\u7403\u5973\u6027\u4e2d\u6700\u5e38\u89c1\u7684\u764c\u75c7\u3002\u5728\u8fc7\u53bb\u5341\u5e74\u4e2d\uff0c\u968f\u7740\u65b0\u836f\u7269\u7684\u5f15\u5165\uff0c\u5982\u5316\u7597\u836f\u7269\u57c3\u745e\u5e03\u6797\u3001\u6297HER2\u5316\u5408\u7269\uff08TDM-1\u3001\u5e15\u59a5\u73e0\u5355\u6297\uff09\u4ee5\u53ca\u7ec6\u80de\u5468\u671f\u6291\u5236\u5242\u5e15\u535a\u897f\u5c3c\uff0c\u4e73\u817a\u764c\u7684\u6cbb\u7597\u53d6\u5f97\u4e86\u663e\u8457\u8fdb\u5c55\u3002\u7136\u800c\uff0c\u665a\u671f\u548c\u8f6c\u79fb\u6027\u4e73\u817a\u764c\u4ecd\u7136\u65e0\u6cd5\u6cbb\u6108\uff0c\u4f9d\u7136\u662f\u764c\u75c7\u76f8\u5173\u6b7b\u4ea1\u7684\u4e3b\u8981\u539f\u56e0\u4e4b\u4e00\u30022012\u5e74\u7ea6\u670911,800\u4eba\u56e0\u4e73\u817a\u764c\u53bb\u4e16\uff0c\u4e2d\u4f4d\u603b\u751f\u5b58\u671f\u4ec5\u4e3a2-3\u5e74\uff0c5\u5e74\u751f\u5b58\u7387\u4ec5\u4e3a25%\u3002\u56e0\u6b64\uff0c\u4ecd\u7136\u5b58\u5728\u5bf9\u65b0\u7597\u6cd5\u7684\u8feb\u5207\u9700\u6c42\u3002<\/p>\n

\u8fc7\u53bb\uff0c\u57fa\u4e8e\u4e73\u817a\u764c\u80bf\u7624\u88ab\u8ba4\u4e3a\u7f3a\u4e4f\u514d\u75ab\u539f\u6027\uff0c\u7814\u7a76\u8005\u5bf9\u4e73\u817a\u764c\u514d\u75ab\u6cbb\u7597\u7684\u5174\u8da3\u4e00\u76f4\u6709\u9650\u3002\u7136\u800c\uff0c\u6700\u65b0\u6570\u636e\u663e\u793a\uff0c\u4e73\u817a\u764c\uff0c\u7279\u522b\u662fHER2\u9633\u6027\u548c\u4e09\u9634\u6027\u4e73\u817a\u764c\uff0c\u5b9e\u9645\u4e0a\u5177\u6709\u514d\u75ab\u539f\u6027\uff0c\u5e76\u4e14\u514d\u75ab\u53cd\u5e94\u7684\u5f3a\u5ea6\u4e0e\u60a3\u8005\u9884\u540e\u5bc6\u5207\u76f8\u5173\u3002\u672c\u6587\u5c06\u8ba8\u8bba\u4e73\u817a\u764c\u4e2d\u514d\u75ab\u6cbb\u7597\u836f\u7269\u7684\u6700\u65b0\u4e34\u5e8a\u8bd5\u9a8c\u7ed3\u679c\uff0c\u5305\u62ec\u75ab\u82d7\u3001\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u4ee5\u53ca\u80bf\u7624\u5fae\u73af\u5883\uff08TME\uff09\u9776\u5411\u836f\u7269\uff0c\u8fd9\u4e9b\u836f\u7269\u5728\u4e73\u817a\u764c\u6cbb\u7597\u4e2d\u663e\u793a\u51fa\u826f\u597d\u7684\u524d\u666f\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.3.1 \u75ab\u82d7<\/p>\n<\/section>\n

\n
\n
\n

\u5728\u8fc7\u53bb\u5341\u5e74\u4e2d\uff0c\u51e0\u79cd\u5b9e\u9a8c\u6027\u764c\u75c7\u75ab\u82d7\u5df2\u5728\u8f6c\u79fb\u6027\u5b9e\u4f53\u7624\u4e2d\u8fdb\u884c\u4e86\u6d4b\u8bd5\uff0c\u4f46\u8fd9\u79cd\u65b9\u6cd5\u4f3c\u4e4e\u5bf9\u665a\u671f\u4e73\u817a\u764c\u7684\u6548\u679c\u6709\u9650\u3002\u8fd1\u5e74\u6765\uff0c\u764c\u75c7\u75ab\u82d7\u7814\u7a76\u51fa\u73b0\u4e86\u8303\u5f0f\u8f6c\u53d8\uff0c\u66f4\u5e38\u5728\u8f85\u52a9\u6cbb\u7597\u6216\u764c\u75c7\u65e9\u671f\u9636\u6bb5\u8fdb\u884c\u6d4b\u8bd5\u3002<\/p>\n

\u57fa\u4e8e\u80bd\u7684\u75ab\u82d7\u662f\u7814\u7a76\u6700\u5e7f\u6cdb\u7684\u4e00\u7c7b\uff0c\u4e3b\u8981\u9776\u5411\u8fc7\u8868\u8fbe\u3001\u6269\u589e\u6216\u7a81\u53d8\u7684\u86cb\u767d\u8d28\uff0c\u5982HER2\u3001MUC1\u3001CEA\u3001p53\u3001\u4e73\u817a\u73e0\u86cb\u767dA\u548c\u764c-\u777e\u4e38\u6297\u539f\u3002<\/p>\n

\u5176\u4e2d\uff0cHER2\u884d\u751f\u75ab\u82d7\u5f97\u5230\u4e86\u5e7f\u6cdb\u7814\u7a76\uff0c\u5c24\u5176\u662fE75\uff08neelipepimut-S, NeuVax\u2122\uff09\u3002\u8fd9\u662f\u4e00\u79cd\u7531\u4eba\u767d\u7ec6\u80de\u6297\u539f\uff08HLA\uff09-A2\/A3\u9650\u5236\u6027\u514d\u75ab\u80bd\u7ec4\u6210\u7684\u75ab\u82d7\uff0c\u6e90\u81eaHER2\u86cb\u767d\u7684\u7ec6\u80de\u5916\u7ed3\u6784\u57df\uff0c\u76ee\u524d\u5df2\u8fdb\u5165\u5f00\u53d1\u7684\u540e\u671f\u9636\u6bb5\u3002\u5728\u8f85\u52a9\u6cbb\u7597\u4e2d\uff0c\u4e00\u9879I\/II\u671f\u8bd5\u9a8c\u62db\u52df\u4e86195\u540dHER2\u9633\u6027\u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u63a5\u79cd\u75ab\u82d7\u7684\u60a3\u80055\u5e74\u65e0\u75c5\u751f\u5b58\u7387\u4e3a89.7%\uff0c\u800c\u5bf9\u7167\u7ec4\u4e3a80.2%\uff0c\u4e14\u4ec5\u8868\u73b0\u51fa\u8f7b\u5fae\u7684\u5c40\u90e8\u548c\u5168\u8eab\u6bd2\u6027\u3002\u57fa\u4e8e\u8fd9\u4e9b\u4ee4\u4eba\u9f13\u821e\u7684\u6570\u636e\uff0c\u65e9\u671f\u4e73\u817a\u764c\u7684III\u671f\u4e34\u5e8a\u7814\u7a76PRESENT\u5df2\u542f\u52a8\uff1b\u7136\u800c\uff0c\u6839\u636e\u72ec\u7acb\u6570\u636e\u76d1\u6d4b\u59d4\u5458\u4f1a\u57282016\u5e746\u6708\u7684\u5efa\u8bae\uff0c\u8be5\u8bd5\u9a8c\u56e0\u672a\u663e\u793a\u51fa\u663e\u8457\u7597\u6548\u800c\u88ab\u7ec8\u6b62\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.3.2 \u514d\u75ab\u68c0\u67e5\u70b9<\/p>\n<\/section>\n

\n
\n
\n

\u9996\u6b21\u514d\u75ab\u6cbb\u7597\u4e34\u5e8a\u8bd5\u9a8c\u7684\u521d\u6b65\u7ed3\u679c\u663e\u793a\uff0c\u67d0\u4e9b\u4e73\u817a\u764c\u786e\u5b9e\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6cbb\u7597\u6709\u53cd\u5e94(Table36.1<\/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 36.1 <\/span>\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u5728\u4e73\u817a\u764c\u4e2d\u7684\u4e3b\u8981\u7ed3\u679c<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.3.2.1 \u8154\u5185\u578b\u4e73\u817a\u764c<\/p>\n<\/section>\n

\n
\n
\n

\u5728\u4e00\u9879I\u671f\u7814\u7a76\u4e2d\uff0c26\u4f8b\u60a3\u8005\u63a5\u53d7\u4e86\u66f2\u7f8e\u6728\u5355\u6297\uff08tremelimumab\uff09\u4e0e\u4f9d\u897f\u7f8e\u5766\uff08\u4e00\u79cd\u82b3\u9999\u5316\u9176\u6291\u5236\u5242\uff09\u7684\u8054\u5408\u6cbb\u7597\u3002\u867d\u7136\u672a\u89c2\u5bdf\u5230\u5ba2\u89c2\u53cd\u5e94\uff0c\u4f46\u6709\u8da3\u7684\u662f\uff0c42%\u7684\u60a3\u8005\u75be\u75c5\u5f97\u5230\u4e86\u81f3\u5c116\u5468\u7684\u7a33\u5b9a\u63a7\u5236\u3002<\/p>\n

\u5728Keynote-028\u8fd9\u9879\u591a\u961f\u5217I\u671f\u8bd5\u9a8c\u4e2d\uff0c25\u4f8bPD-L1\u9633\u6027\u8154\u5185\u4e73\u817a\u764c\u60a3\u8005\u63a5\u53d7\u4e86\u6297PD-1\u836f\u7269\u5e15\u59c6\u73e0\u5355\u6297\u7684\u6cbb\u7597\u3002\u5728\u8fd9\u7fa4\u91cd\u5ea6\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\uff0c\u603b\u7f13\u89e3\u7387\u4e3a12%\uff0c\u4e34\u5e8a\u83b7\u76ca\u7387\u4e3a20%\u3002\u5728JAVELIN\u7814\u7a76\u4e2d\uff0c\u65e0\u8bba\u60a3\u8005\u7684PD-L1\u72b6\u6001\u5982\u4f55\uff0c\u6240\u6709\u60a3\u8005\u5747\u63a5\u53d7\u4e86\u963f\u7ef4\u9c81\u5355\u6297\uff08avelumab\uff0c\u4e00\u79cd\u6297PD-L1\u836f\u7269\uff09\u6cbb\u7597\u3002\u5728\u8154\u5185\u578b\u4e73\u817a\u764c\u961f\u5217\u4e2d\uff0c\u603b\u7f13\u89e3\u7387\uff08ORR\uff09\u4ec5\u4e3a2.8%\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.3.2.2 \u4e09\u9634\u6027\u4e73\u817a\u764c<\/p>\n<\/section>\n

\n
\n
\n

Keynote-012\u662f\u9996\u4e2a\u62a5\u9053\u6297PD-1\u6cbb\u7597\u8f6c\u79fb\u6027\u4e09\u9634\u6027\u4e73\u817a\u764c\u4e34\u5e8a\u7ed3\u679c\u7684\u8bd5\u9a8c\u3002\u8fd9\u9879Ib\u671f\u7814\u7a76\u572827\u4f8bPD-L1\u9633\u6027\u60a3\u8005\u4e2d\u8bc4\u4f30\u4e86\u5e15\u59c6\u5355\u6297\uff08Pembrolizumab\uff09\u7684\u7597\u6548\u30026\u4e2a\u6708\u65f6\uff0c\u5e15\u59c6\u5355\u6297\u7684\u603b\u4f53\u7f13\u89e3\u7387\uff08ORR\uff09\u4e3a18.5%\uff0c\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\uff08PFS\uff09\u4e3a23%\u3002\u53e6\u4e00\u79cdPD-L1\u6291\u5236\u5242\u963f\u7279\u73e0\u5355\u6297\uff08Atezolizumab\uff09\u4e5f\u5728\u8fd9\u4e00\u4eba\u7fa4\u4e2d\u8fdb\u884c\u4e86\u8bc4\u4f30\uff0c\u5355\u836f\u6cbb\u7597\u663e\u793a\u51fa\u7c7b\u4f3c\u7684\u6548\u679c\u3002\u5728PD-L1\u9633\u6027\u4eba\u7fa4\u4e2d\uff0cORR\u4e3a24%\uff0c6\u4e2a\u6708\u65f6\u7684PFS\u4e3a27%\u3002\u5728JAVELIN\u7814\u7a76\u4e2d\uff0c\u975e\u9009\u62e9\u6027\u4eba\u7fa4\u4e2d\u963f\u7ef4\u9c81\u5355\u6297\uff08Avelumab\uff09\u7684ORR\u4e3a8.6%\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\uff0c\u68c0\u67e5\u70b9\u6291\u5236\u5242\u4e0e\u5316\u7597\u7684\u8054\u5408\u4f7f\u7528\u6b63\u5728\u79ef\u6781\u63a2\u7d22\u4e2d\u3002\u5728\u4e00\u9879I\u671f\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\uff0c\u8054\u5408\u4f7f\u7528\u963f\u7279\u73e0\u5355\u6297\u4e0enab-\u7d2b\u6749\u9187\u7684\u6cbb\u7597\uff0c\u65e0\u8bbaPD-L1\u72b6\u6001\u5982\u4f55\uff0cORR\u5747\u4e3a38%\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u8d85\u8fc780%\u7684\u60a3\u8005\u6b64\u524d\u66fe\u63a5\u53d7\u8fc7\u7d2b\u6749\u70f7\u6cbb\u7597\u3002\u57fa\u4e8e\u8fd9\u4e9b\u4ee4\u4eba\u9f13\u821e\u7684\u6570\u636e\uff0cIMpassion130\u8fd9\u9879III\u671f\u7814\u7a76\u76ee\u524d\u6b63\u5728\u8fdb\u884c\u4e2d\uff0c\u6bd4\u8f83\u4e86nab-\u7d2b\u6749\u9187\u8054\u5408\u963f\u7279\u73e0\u5355\u6297\u4e0enab-\u7d2b\u6749\u9187\u8054\u5408\u5b89\u6170\u5242\u7684\u4e00\u7ebf\u6cbb\u7597\u6548\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u57282016\u5e74\u5723\u5b89\u4e1c\u5c3c\u5965\u4e73\u817a\u764c\u7814\u8ba8\u4f1a\uff08SABCS\uff09\u4e0a\uff0cTolaney\u7b49\u4eba\u4e5f\u62a5\u9053\u4e86\u5e15\u59c6\u5229\u73e0\u5355\u6297\uff08Pembrolizumab\uff09\u4e0e\u57c3\u65e5\u5e03\u6797\u8054\u5408\u6cbb\u7597\u7684\u79ef\u6781\u7ed3\u679c\u3002\u5728\u4e00\u9879Ib\/II\u671f\u7814\u7a76\u4e2d\uff0c\u8054\u5408\u6cbb\u7597\u5728\u65e2\u5f80\u63a5\u53d7\u8fc7\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\u663e\u793a\u51fa33.3%\u7684ORR\u3002\u6b64\u5916\uff0c\u65e0\u8bbaPD-L1\u72b6\u6001\u5982\u4f55\uff0c\u4e00\u7ebf\u6cbb\u7597\u60a3\u8005\u7684ORR\u4e3a41%\u3002<\/p>\n

\u603b\u4f53\u6765\u770b\uff0c\u5bf9\u4e8e\u8fd9\u4e9b\u65e2\u5f80\u63a5\u53d7\u8fc7\u5927\u91cf\u6cbb\u7597\u4e14\u5316\u7597\u8010\u836f\u7684\u4e09\u9634\u6027\u4e73\u817a\u764c\u60a3\u8005\uff0c\u8fd9\u4e9b\u7f13\u89e3\u7387\u53ef\u80fd\u4f18\u4e8e\u9884\u671f\u3002\u66f4\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u5f53\u60a3\u8005\u51fa\u73b0\u53cd\u5e94\u65f6\uff0c\u8fd9\u4e9b\u53cd\u5e94\u901a\u5e38\u662f\u6301\u4e45\u7684\uff0c\u6709\u65f6\u6301\u7eed\u8d85\u8fc71\u5e74\u3002\u8fd9\u79cd\u73b0\u8c61\u5728\u5176\u4ed6\u80cc\u666f\u4e0b\u7684\u514d\u75ab\u6cbb\u7597\u4e2d\u5df2\u6709\u62a5\u9053\uff0c\u4f46\u5728\u6b64\u524d\u63a5\u53d7\u8fc7\u5927\u91cf\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\uff0c\u5316\u7597\u901a\u5e38\u4e0d\u4f1a\u6709\u5982\u6b64\u6301\u4e45\u7684\u6548\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

36.3.2.3 \u4e73\u817a\u764c\u7814\u7a76\u7684\u672a\u6765\u65b9\u5411<\/p>\n<\/section>\n

\n
\n
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\u9884\u8ba1\u672a\u6765\u5bf9\u4e73\u817a\u764c\u514d\u75ab\u6cbb\u7597\u7684\u7814\u7a76\u5174\u8da3\u5c06\u7ee7\u7eed\u589e\u957f\uff0c\u8bb8\u591a\u8bd5\u9a8c\u6b63\u5728\u8bc4\u4f30\u5404\u79cd\u514d\u75ab\u6cbb\u7597\u65b9\u6cd5\uff0c\u5305\u62ec\u5355\u514b\u9686\u6297\u4f53\u3001\u75ab\u82d7\u3001\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u5242\uff0c\u4ee5\u53ca\u57fa\u56e0\u5de5\u7a0bT\u7ec6\u80de\u6216\u514d\u75ab\u8c03\u8282\u5242\uff08\u5982\u7ec6\u80de\u56e0\u5b50\u6216Toll\u6837\u53d7\u4f53\uff08TLR\uff09\u6fc0\u52a8\u5242\uff09\u5728\u8fc7\u7ee7T\u7ec6\u80de\u6cbb\u7597\u4e2d\u7684\u5e94\u7528\u3002<\/p>\n

\u4e73\u817a\u764c\u514d\u75ab\u6cbb\u7597\u7684\u6210\u529f\u53ef\u80fd\u53d6\u51b3\u4e8e\u4e3a\u7279\u5b9a\u7684\u75be\u75c5\u7c7b\u578b\u548c\u9636\u6bb5\u786e\u5b9a\u5408\u9002\u7684\u514d\u75ab\u6cbb\u7597\u7b56\u7565\u3002\u4f8b\u5982\uff0c\u8f6c\u79fb\u6027\u75c5\u7076\u7684\u5fae\u73af\u5883\u901a\u5e38\u5bf9\u514d\u75ab\u7cfb\u7edf\u975e\u5e38\u4e0d\u5229\uff0c\u514d\u75ab\u6291\u5236\u6027\u7ec6\u80de\u56e0\u5b50\u548c\u7ec6\u80de\u5728\u5176\u4e2d\u6709\u6548\u5730\u6291\u5236\u4e86\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u3002\u5c3d\u7ba1\u7814\u7a76\u8868\u660e\u4e73\u817a\u80bf\u7624\u5177\u6709\u4e00\u5b9a\u7684\u514d\u75ab\u539f\u6027\uff0c\u4f46\u514d\u75ab\u53cd\u5e94\u5e76\u4e0d\u603b\u662f\u5f3a\u70c8\u3002\u4e00\u9879\u7814\u7a76\u62a5\u544a\u6307\u51fa\uff0c\u6fc0\u7d20\u53d7\u4f53\u9633\u6027\u4e73\u817a\u764c\u4e2d\u6d78\u6da6TILs\u7684\u95f4\u8d28\u9762\u79ef\u4e2d\u4f4d\u767e\u5206\u6bd4\u4ec5\u4e3a10%\uff0cHER2\u9633\u6027\u4e73\u817a\u764c\u4e3a15%\uff0c\u800c\u4e09\u9634\u6027\u4e73\u817a\u764c\uff08TNBC\uff09\u4e3a20%\u3002\u7531\u4e8e\u514d\u75ab\u6d78\u6da6\u7684\u7f3a\u4e4f\uff0c\u68c0\u67e5\u70b9\u963b\u65ad\u5242\u53ef\u80fd\u65e0\u6cd5\u5355\u72ec\u53d1\u6325\u663e\u8457\u7684\u6cbb\u7597\u6548\u679c\u3002<\/p>\n

\u56e0\u6b64\uff0c\u523a\u6fc0\u514d\u75ab\u53cd\u5e94\u7684\u7b56\u7565\uff0c\u5982\u4f7f\u7528\u75ab\u82d7\u6216Toll\u6837\u53d7\u4f53\u6fc0\u52a8\u5242\uff0c\u53ef\u80fd\u66f4\u6709\u6548\u3002\u8fd9\u4e9b\u7b56\u7565\u80fd\u591f\u6fc0\u53d1\u514d\u75ab\u53cd\u5e94\uff0c\u968f\u540e\u901a\u8fc7\u68c0\u67e5\u70b9\u963b\u65ad\u5242\u6765\u589e\u5f3a\u548c\u7ef4\u6301\u8fd9\u79cd\u53cd\u5e94\uff0c\u4ece\u800c\u4e3a\u4e73\u817a\u764c\u60a3\u8005\u5e26\u6765\u66f4\u597d\u7684\u6cbb\u7597\u6548\u679c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8fd1\u5e74\u6765\uff0c\u514d\u75ab\u6cbb\u7597\u5728\u591a\u79cd\u764c\u75c7\u7c7b\u578b\u4e2d\u53d6\u5f97\u4e86\u663e\u8457\u8fdb\u5c55\uff0c\u4e73\u817a\u764c\u548c\u5987\u79d1\u6076\u6027\u80bf\u7624\u4e5f\u4e0d\u4f8b\u5916\u3002\u65e9\u671f\u6570\u636e\u663e\u793a\uff0c\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u5728\u8fd9\u4e9b\u764c\u75c7\u4e2d\u5c55\u73b0\u51fa\u5e0c\u671b\uff0c\u8868\u660e\u5b83\u4eec\u53ef\u80fd\u6210\u4e3a\u672a\u6765\u6cbb\u7597\u7684\u91cd\u8981\u7ec4\u6210\u90e8\u5206\u3002\u7136\u800c\uff0c\u8fd9\u4e9b\u6570\u636e\u540c\u65f6\u8868\u660e\uff0c\u68c0\u67e5\u70b9\u6291\u5236\u5242\u5355\u72ec\u4f7f\u7528\u5e76\u975e\u5728\u6240\u6709\u60a3\u8005\u4e2d\u90fd\u6709\u6548\uff0c\u8fd9\u51f8\u663e\u4e86\u5408\u7406\u8bbe\u8ba1\u6cbb\u7597\u7ec4\u5408\u7684\u5fc5\u8981\u6027\u3002<\/p>\n

\u6fc0\u6d3b\u6700\u4f73\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\u9700\u8981\u9488\u5bf9\u514d\u75ab\u7cfb\u7edf\u4e0d\u540c\u7ec4\u6210\u90e8\u5206\u7684\u7efc\u5408\u7b56\u7565\u3002\u7531\u4e8e\u514d\u75ab\u9003\u907f\u673a\u5236\u5728\u60a3\u8005\u4e4b\u95f4\u5b58\u5728\u5dee\u5f02\uff0c\u6cbb\u7597\u65b9\u6848\u53ef\u80fd\u9700\u8981\u4e2a\u6027\u5316\u8bbe\u8ba1\u3002\u901a\u8fc7\u5728\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u5f15\u5165\u9002\u5f53\u7684\u751f\u7269\u6807\u5fd7\u7269\uff0c\u6211\u4eec\u53ef\u4ee5\u66f4\u7cbe\u51c6\u5730\u4e3a\u60a3\u8005\u9009\u62e9\u9002\u5408\u7684\u6cbb\u7597\u65b9\u6cd5\uff0c\u5e76\u4e3a\u5f00\u53d1\u548c\u5e94\u7528\u8054\u5408\u7597\u6cd5\u63d0\u4f9b\u5173\u952e\u4fe1\u606f\uff0c\u4ece\u800c\u5e2e\u52a9\u514b\u670d\u5f53\u524d\u7684\u6cbb\u7597\u5c40\u9650\u6027\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\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 | \u51bc\u91d1\u6b22<\/span><\/p>\n

\u56fe\u6587\u6392\u7248 | \u59da\u4f69\u8a00 \u9093\u8d8a\u534e<\/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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\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

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\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

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

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