刘永军 徐稳

    [摘要] 程序性死亡因子-1(PD-1)及其配体PD-L1抑制剂通过阻断PD-1与PD-L1的结合而使负向调控信号受阻，导致T细胞恢复活性，从而增强免疫应答。目前已被批准上市的靶向PD-1/PD-L1药物主要有Nivolumab、Pembrolizumab、Atezolizumab等，临床研究结果显示PD-1/PD-L1抑制剂单药或联合ipilimumab治疗黑色素瘤、二线治疗PD-L1阳性的晚期非小细胞肺癌均有明确的效果，同时，应用于治疗乳腺癌、头颈癌、胃癌、尿路上皮癌、淋巴瘤等恶性肿瘤的临床试验正积极展开。目前PD-1/PD-L1抑制剂存在潜在的严重不良反应、治疗模式难以确定、疗效难以评价和价格昂贵等问题。本研究主要对PD-1/PD-L1抑制剂的作用机制、现况及其在不同肿瘤治疗中的应用效果进行综述，指出存在的问题，为后续研究和政府相关政策制定提供部分思路和依据。

    [关键词] 肿瘤；免疫疗法；程序性死亡因子-1；程序性死亡因子-1配体

    [中图分类号] R730.51 [文献标识码] A [文章编号] 1673-7210(2018)06(a)-0038-04

    [Abstract] Programmed cell death-1(PD-1) and its ligand PD-L1 inhibitors can inhibit PD-1 and PD-L1 combination to block negative control signals， leading to activity of T cells and enhancement of immune responses. Targeted PD-1/PD-L1 drugs currently approved for marketing include Nivolumab， Pembrolizumab， Atezolizumab， etc. Clinical studies have shown that PD-1/PD-L1 inhibitors have a definite effect on monotherapy or combined with ipilimumab for the treatment of melanoma and second-line treatment PD-L1 positive advanced non-small cell lung cancer. At the same time， clinical trials for the treatment of breast cancer ......