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中药在免疫检查点抑制剂抗肿瘤治疗中的增效减毒作用与研究进展OA

Efficacy-enhancing and toxicity-reducing effects of TCM in immune checkpoint inhibitor-based anti-tumor therapy:a review of mechanisms and advances

中文摘要英文摘要

免疫检查点抑制剂(ICIs)通过阻断免疫检查点分子,激活抗肿瘤免疫应答,已成为肿瘤治疗的重要突破.然而,ICIs的耐药性和免疫相关不良事件(irAEs)严重限制其临床应用.中医药基于整体观与辨证施治的理论,凭借其独特的免疫调节作用和多靶点、多通路作用机制,在提高ICIs疗效方面展现出显著优势.研究表明,中药可能通过调节肿瘤微环境、干预关键免疫信号通路以及调节肠道菌群稳态等多种机制,有效增强T细胞抗肿瘤活性,改善ICIs耐药性.同时,中药在缓解ICIs引发的结肠炎、肺炎、心脏毒性等irAEs,提高患者的治疗耐受性方面也显示出良好应用前景.该文系统综述了中药联合ICIs治疗的协同作用机制与研究进展,旨在为优化肿瘤免疫治疗策略提供新思路.未来,基于中西医结合的精准治疗模式有望为癌症患者提供更安全、高效的治疗方案,推动肿瘤免疫治疗的持续发展.

Immune checkpoint inhibitors(ICIs)have become a significant breakthrough in cancer therapy by activating anti-tumor immune responses through the blockade of immune checkpoint molecules.However,acquired resistance to ICIs and immune-related adverse events(irAEs)severely limit their clinical application.TCM,based on the principles of holistic view and syndrome differentiation-based treatment,demonstrates distinct advantages in enhancing ICIs efficacy due to its unique immunomodulatory effects and multi-target,multi-pathway mechanisms.Studies suggest that TCM may effectively enhance T cell-mediated anti-tumor activity and improve ICIs resistance through various mechanisms,including modulating the tumor microenvironment,intervening in key immune signaling pathways,and restoring gut microbiota homeostasis.Additionally,TCM shows promising potential in alleviating ICIs-induced irAEs,such as colitis,pneumonitis,and cardiotoxicity,thereby improving patient tolerance to treatment.This review systematically summarizes the synergistic mechanisms and recent research progress in the combined use of TCM and ICIs,aiming to provide novel insights for optimizing cancer immunotherapy strategies.In the future,a precision medicine model integrating TCM and western medicine may offer safer and more effective therapeutic options for cancer patients,further advancing the development of tumor immunotherapy.

王渲强;陈炜聪;赵璐

浙江大学 药学院,浙江 杭州 310058浙江大学 药学院,浙江 杭州 310058浙江大学 药学院,浙江 杭州 310058||浙江大学 现代中药创制全国重点实验室,浙江 杭州 310058

癌症中药免疫检查点抑制剂免疫相关不良事件肿瘤微环境

cancerTCMimmune checkpoint inhibitorimmune-related adverse eventtumor microenvironment

《中国中药杂志》 2026 (5)

1250-1258,9

国家重点研发计划项目(2024YFC3506601)

10.19540/j.cnki.cjcmm.20251219.501

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