2016年癌症领域12项颠覆性创新技术,细胞免疫治疗居首

2016-05-08 MedSci MedSci原创

美国联盟医疗体系在其举办的第二届世界医学创新峰会(World Medical Innovation Forum)中公布了由哈佛医学院专家选出的12项“颠覆性”的创新癌症诊断和治疗技术,有可能在10年内为癌症治疗带来革命性的改变。1. 细胞免疫治疗嵌合抗原受体(CAR)可以让T细胞靶向识别特定的肿瘤细胞。尽管该领域的开发仍处于早期,但许多癌症患者在其他方法都没有效果之后,对这种嵌合抗原受体T细胞

美国联盟医疗体系在其举办的第二届世界医学创新峰会(World Medical Innovation Forum)中公布了由哈佛医学院专家选出的12项“颠覆性”的创新癌症诊断和治疗技术,有可能在10年内为癌症治疗带来革命性的改变。

1. 细胞免疫治疗


嵌合抗原受体(CAR)可以让T细胞靶向识别特定的肿瘤细胞。尽管该领域的开发仍处于早期,但许多癌症患者在其他方法都没有效果之后,对这种嵌合抗原受体T细胞疗法(CAR T)出现“史无前例”的应答。最新的研究正在探索如何最好地将CAR T和其他免疫疗法相结合。CAR T细胞联合检查点抑制剂如PD-1抑制剂和抗CTLA4药物是很有前景的疗法。癌症专家预计,通过修改患者自身的免疫系统攻击并打败癌症,CAR T疗法今后有可能成为一种首要的癌症疗法。

2. 免疫调节剂(检查点抑制剂)和疫苗

针对PD-1或PD-L1通路的检查点抑制剂在癌症治疗方面取得了令人瞩目的成果,使其快速走出实验室获得FDA批准。其独特的机制修补了机体自身的免疫系统,激发自身的抵抗力,在一些案例中产生了长期的癌症缓解甚至是治愈,特别是联合其它的标准抗癌疗法。新型疫苗也在开发中,可以扩增抗击癌症的免疫细胞群,从而产生抗癌效果。疫苗目前正在多种恶性疾病中进行试验,一旦获得批准,医生们将可以获得治疗晚期癌症的极大进展。

3. 癌症液体活检

这是一种新型的血液检测,有可能使患者在诊断和治疗癌症的过程中,免于接受外科或针吸活检,还可以在治疗过程中反复取样。液体活检依靠的是捕获血液中的癌细胞(循环肿瘤细胞,CTC),分离出叫做胞外体或游离肿瘤DNA的细胞碎片,然后进行分子学分析,可用于诊断和指导治疗方案。随着基因测序的资本化运作以及基因检测成本的下降,有数十家公司目前正在开发液体活检。许多医生认为液体活检可以让更多的人享受到个性化医疗。

4. 机器学习和计算生物学

为了探究癌症的起因和开发更有效的癌症预防、检测和治疗方法,研究人员需要研究大量的分子和临床数据。美国和欧洲研究机器学习的领先机构以及统计遗传学现在正在通力合作,开发强大的生物标志物发现技术和阐明癌症的发病机制和进展原因。通过收集最新的患者生物信息和成千上万其他癌症患者产生的以万亿计的数据,医生可以在几天甚至几分钟之内为患者量身定制合适的癌症治疗方案。最终,这些信息会加入到庞大的数据库中,帮助全世界的癌症研究者发掘抗击癌症的方法。

5. 表观遗传学和癌症治疗

在癌症患者中,调整表观遗传学的能力对于重置细胞状态和可塑性至关重要。研究人员发现一些造成癌症的表观遗传学改变可以通过新疗法逆转,这在一些案例中较传统化疗毒性更小。表观遗传学方法不仅会改变研究者对癌症的看法,还会改变癌症的治疗方法。新的表观遗传学治疗方法不是杀死癌细胞,而是将病变细胞转化为正常细胞或使其对现有疗法或新疗法更敏感。对癌症细胞DNA包装差异的理解可以帮助医生选择更精准有效的药物,靶向治疗肿瘤细胞中特定的表观靶点,从而获得疾病的缓解甚至治愈。

6. 人体微生物组和癌症

尽管该技术仍处于“婴儿”阶段,人体微生物组研究领域正在不断发展,科学家们知道了更多微生物在癌症形成、疾病进展和治疗应答中所起的作用。对肠道菌群作用的深入了解有助于开发个性化的介入方法,预防或减轻癌症患者的微生物失衡,从而减轻症状。许多商业公司开始研发商业化的基于微生物的癌症免疫疗法,使用特定的肠道菌群激发免疫系统攻击癌症细胞,增加抗癌药物的效果。探索微生物的治疗效果为开发新疗法提供了无限可能。

7. CRISPR:基因编辑和癌症

CRISPR是短回文重复序列的缩写,因其可以让科学家更容易、快速和精确地改变DNA的基因编码而风靡世界。一些人认为CRISPR基因编辑可以称得上是过去100年来最重要的生物学工具之一。这一技术可以用来发现新的癌症治疗靶点,从替代基因编辑到靶向免疫抗癌细胞,将使癌症治疗进入新的世界。

8. 单细胞分子分析

当癌症发生时,一个细胞的恶变可能会导致整个机体的毁灭。因此科学家们正在研究如何对单个细胞进行衡量、识别、描述和分类。一些技术可以放大单个细胞的物质,还有技术可以多重处理多个细胞。随着细胞捕获、分型、分子分析技术的快速发展,将来会有无数生物和医学上的应用。在未来几年内,单细胞分析将有助于回答癌症研究的一些重大问题,包括解决肿瘤内异质性、跟踪细胞族系、了解罕见肿瘤细胞群、以及衡量突变率。这些工具还可以应用到临床领域,包括早期癌症检查、无创性监测、指导靶向治疗等。此外,对癌症进展时细胞浸润、转移和抗药性的深入了解也对癌症的治疗有极大的帮助。

9. 移动医疗和癌症治疗

移动医疗技术不仅可以获取患者的健康状况,也可以让医生实时了解癌症患者在家中和日常活动时的情况。谷歌、苹果、微软等重量级选手都参与到移动医疗领域,通过利用智能设备和可穿戴设备增加了治疗和研究介入的机会。新型癌症护理应用程序可以提供新的廉价的癌症支持路径,可以提高癌症患者的生活质量,提供患者教育,就医导航,以及个性化社会支持。这些都最终会降低医疗成本,提高患者的生活质量。

10. 个体化研究提高药物研发效率

新的研究策略可以基于患者的病史、癌症分期和病理预测治疗的效果,这将在未来几年起到越来越重要的作用。为了解决治疗应答的差异性和复杂性,医生将根据肿瘤的各种参数使用计算机建模,例如基因和蛋白质组数据、肿瘤细胞功能分析、药物剂量和先前的治疗数据。许多研究人员认为这种新型的试验设计可以提高监管的成功率,并且可以更快地向可能对一些治疗有效的癌症患者提供性价比更高的药物。

11. 重新定义癌症治疗的价值

由于技术的进步及人口的老龄化,癌症医疗将会是医疗卫生支出的一个主要增长因素。癌症治疗产业内的参与者们将一起分享癌症相关的数据,制定衡量癌症治疗领域进展的标准。越来越多的患者和患者组织将参与到决策制定中来,各领域的决策者将一起管理复杂的癌症、寻找不同的支付模式、通过指南规范癌症治疗,减少浪费,例如通过基因分析(精准医疗)设计试验,避免效果有限的治疗方法。这种合作方式将有助于改进癌症的预防、检查和治疗,降低经济负担,使得治疗的价格可以真实反映治疗的效果。

12. 纳米技术和癌症治疗

纳米技术有可能有选择性地直接将药物输送到癌症细胞中,指导肿瘤的手术切除,加强放疗的治疗效果,而且还可以助力基因编辑、基因疗法等辅助技术。纳米技术的研发速度很快,呈直线上升的趋势。预计纳米技术将开始进入临床试验,而且随着纳米技术在免疫治疗、基因疗法、RNA干扰、基因编辑等领域的应用,我们将见识到纳米技术的强大力量,将会极大提高癌症患者的存活率。

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  3. 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    2016-08-27 李东泽

    这篇资讯带给我们新知识,启发新思维,不论是科研还是临床工作都有很大的帮助。。。

    0

  4. 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    2016-08-27 李东泽

    这篇资讯带给我们新知识,启发新思维,不论是科研还是临床工作都有很大的帮助。。。

    0

  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun May 08 21:15:00 CST 2016, time=2016-05-08, status=1, ipAttribution=)]
    2016-05-10 小猫cathy

    对其中的一些研究感兴趣

    0

  6. 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    2016-05-09 jaysppr

    细胞免疫的前途很大,但是媒体的不良宣传影响太大

    0

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likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 10:31:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84859, encodeId=713c8485970, content=关注中!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160229/IMG56D321252C0101765.jpg, createdBy=e2381693259, createdName=Janine 9795, createdTime=Mon May 09 00:54:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84809, encodeId=4d8984809af, content=学习了,值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun May 08 21:15:00 CST 2016, time=2016-05-08, status=1, ipAttribution=)]
    2016-05-09 Janine 9795

    关注中!

    0

  10. 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    2016-05-08 dhzzm

    学习了,值得关注

    0