Compared with traditional treatment methods,
tumor immunotherapy has its own characteristics: Surgical treatment • Traditional surgery: • For early solid tumors, if the tumor tissue can be completely removed, the radical effect can be achieved, the lesion can be quickly removed, and the patient may achieve clinical cure in a short time. However, the surgical trauma is large, and it is often powerless for advanced metastatic tumors. • In contrast to immunotherapy: • Immunotherapy usually does not directly remove the tumor, but mobilizes the immune system to attack the tumor, which generally takes effect relatively slowly. However, for some patients with unresectable advanced tumors, immunotherapy can control tumor progression, prolong survival, and even reduce the tumor to resectable range in some cases. Radiotherapy • Traditional radiotherapy: • High-energy radiation is used to kill tumor cells, which has a good effect on local tumor control, especially for some radiation-sensitive tumors, such as nasopharyngeal carcinoma. However, radiotherapy can also cause some damage to the surrounding normal tissues, cause adverse reactions such as radioactive inflammation, and it is difficult to completely remove distant metastatic tumor cells. • In contrast to immunotherapy: • Immunotherapy is a systemic effect, not only on local tumors, but also on potential metastatic lesions. When used in combination with radiotherapy, it can sometimes enhance the anti-tumor effect of radiotherapy and improve the survival rate of patients. Chemotherapy • Traditional chemotherapy: • Through the use of chemical drugs to kill tumor cells, it can act on tumor cells throughout the body and has a certain effect on a variety of tumors. However, the lack of specificity of chemotherapy drugs will damage normal cells at the same time, leading to serious adverse reactions, such as nausea, vomiting, alopecia, bone marrow suppression, and prone to drug resistance of tumors. Compared with immunotherapy, immunotherapy has relatively strong specificity, mainly activates the autoimmune system to fight against tumors, and normal cells are relatively less affected. The types of adverse reactions are different from those of chemotherapy, most of which are immune-related adverse reactions such as immune pneumonia. Some patients who are resistant to chemotherapy may still respond to immunotherapy, but immunotherapy is not effective for all patients, and the efficiency needs to be improved. In general, tumor immunotherapy provides new ideas and means for tumor treatment, and has its own advantages and disadvantages compared with traditional treatment methods. In actual clinical application, they are often used in combination to play a better comprehensive therapeutic effect. The development of tumor immunotherapy is roughly as follows: Early exploration stage (from the end of the 19th century to the middle of the 20th century): • In 1891, William Coley, an American doctor, tried to treat tumors with bacterial toxins, which started the exploration of tumor immunotherapy, but at that time, the understanding of its mechanism was limited. Application stage of immunomodulators (from the middle of the 20th century to the end of the 20th century): • It has been found that some immunomodulators such as BCG vaccine can affect tumor progression to a certain extent, but the effect is not stable. Cytokine era (1980s to the beginning of the 21st century): • a variety of cytokines such as interferon and interleukin were discovered and applied for tumor treatment, and some patients had certain curative effect, but the adverse reactions were obvious. The rise of immune checkpoint inhibitors (early 2000s to present): • In 2011, the first CTLA-4 inhibitor was approved for marketing. • The emergence of PD-1/PD-L1 inhibitors has greatly changed the treatment pattern of various tumors and achieved remarkable results in the treatment of melanoma, lung cancer and other cancers. Development of cellular immunotherapy (from the 21st century to the present): • Adoptive cellular immunotherapy technologies such as CAR-T cell therapy have gradually matured, showing outstanding effects in the treatment of hematological tumors, and are also expanding to the treatment of solid tumors. With the continuous development of cancer immunotherapy, it is expected to bring better therapeutic effect to more cancer patients in the future.
