鼻腔鼻窦恶性肿瘤的免疫特征与免疫治疗疗效：范围综述

文献信息

中文摘要

目的： 目前对免疫治疗策略治疗鼻腔鼻窦恶性肿瘤（SN）的疗效及其免疫学特征知之甚少。本综述总结了SN肿瘤中的关键免疫标志物，并强调了关于检查点抑制剂疗效的已知数据。
数据来源： 检索了MEDLINE、Embase、Cochrane对照试验中心注册库和Web of Science数据库，检索时间自建库至当前，以识别关于SN恶性肿瘤的研究，包括SN鳞状细胞癌（SNSCCa）、腺癌（SNAC）、未分化癌（SNUC）和嗅神经母细胞瘤（ONB），及其免疫特征和免疫治疗疗效。
综述方法： 纳入的研究为调查肿瘤免疫特征（细胞或分子）或报告使用免疫检查点抑制剂后结果的研究。两个独立的双人评审团队对675项研究进行了双重独立筛选和全文审查，最终纳入52项研究进行分析。
结果： 抗程序性细胞死亡蛋白-1（PD-1）免疫治疗是研究最多的针对SN恶性肿瘤的免疫检查点抑制剂。检查点抑制剂的疗效在SNSCCa中显示出最大希望，而在SNAC、SNUC和ONB中的研究相对较少。肿瘤浸润淋巴细胞（TIL）密度和程序性死亡配体-1（PD-L1）表达的预后价值在SN肿瘤亚型之间差异很大。在SNSCCa、SNAC和SNUC中，与生存最一致相关的是TILs，而非PD-L1表达。ONB主要为免疫冷肿瘤。
结论： SN肿瘤的罕见性和异质性限制了免疫治疗疗效和预后生物标志物的研究。旨在评估检查点抑制剂疗效和SN肿瘤免疫微环境的多机构研究对于推进SN肿瘤管理至关重要。

英文摘要

OBJECTIVE: Little is understood about the efficacy of immunotherapeutic strategies against sinonasal malignancies (SN) or their immunologic profiles. This review summarizes key immune markers within SN tumors and underscores known data on the efficacy of checkpoint inhibitors.
DATA SOURCES: The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched from database inception to present to identify studies on SN malignancies, including SN squamous cell carcinoma (SNSCCa), adenocarcinoma (SNAC), undifferentiated carcinoma (SNUC), and olfactory neuroblastoma (ONB), their immune profiles, and immunotherapy efficacy.
REVIEW METHODS: Included studies were those that either investigated the tumor immune profile (cellular or molecular) or reported findings following the use of immune checkpoint inhibitors. Two separate teams of two reviewers performed dual, independent screening and full-text review of 675 studies, with 52 included in the final analysis.
RESULTS: Anti-programmed cell death protein-1 (PD-1) immunotherapy is the most investigated immune checkpoint inhibitor against SN malignancies. Checkpoint inhibitor efficacy showed the most promise for SNSCCa with comparatively few studies in SNAC, SNUC, and ONB. The prognostic value of tumor-infiltrating lymphocytes (TIL) density and programmed death ligand-1 (PD-L1) expression vary greatly between SN tumor subtypes. TILs, not PD-L1 expression, most consistently correlate with survival in SNSCCa, SNAC, and SNUC. ONBs are predominantly immune-cold.
CONCLUSION: SN tumor rarity and heterogeneity limits research in immunotherapy efficacy and prognostic biomarkers. Multi-institutional research endeavors aimed at evaluating both checkpoint inhibitor efficacy and the SN tumor immune microenvironment are essential in advancing SN tumor management.