从“天价”到普惠：肿瘤免疫治疗十年巨变，进入“全周期可及”新时代

Core Viewpoint - The establishment of the Jiangsu Provincial Anti-Cancer Association's Tumor Immunology and Biological Therapy Professional Committee marks a significant advancement in the field of cancer treatment, particularly in immunotherapy, which is evolving from high-cost treatments to more accessible options covered by insurance, thereby transforming cancer treatment in China [1][6]. Group 1: Immunotherapy Development - Immunotherapy is often misunderstood as merely "enhancing immunity," whereas it primarily involves immune checkpoint inhibitors like PD-1/PD-L1, which reactivate T cells to target cancer cells [2]. - The history of immunotherapy includes key milestones from the discovery of PD-1 in the early 1990s to the approval of the first PD-1 inhibitor in 2014 and the Nobel Prize awarded in 2018 for foundational research in this area [2]. Group 2: Accessibility and Application - Immunotherapy has transitioned from being prohibitively expensive to a more affordable treatment option due to the introduction of domestic drugs and insurance coverage, making it accessible to a broader population [3]. - The application of immunotherapy has expanded beyond late-stage cancer to include various stages of treatment for multiple cancer types, such as esophageal cancer, lung cancer, and triple-negative breast cancer, among others [3]. Group 3: Synergy with Radiotherapy - The synergy between radiotherapy and immunotherapy can enhance treatment outcomes, particularly for patients with locally advanced esophageal cancer, by improving the tumor microenvironment and activating systemic anti-tumor immunity [4]. - Clinical data indicate that combining radiotherapy with immunotherapy can significantly increase the pathological complete response rate in certain patients [4]. Group 4: Rational Perspective on Immunotherapy - While acknowledging the effectiveness of immunotherapy, it is essential to view it as a tool rather than a universal solution, as its efficacy is closely linked to biomarkers like PD-L1 expression and tumor mutation burden [5]. - Effective management of side effects is crucial, as immunotherapy can lead to severe adverse reactions, necessitating treatment in experienced medical centers with close monitoring [5]. Group 5: Future Directions - The establishment of the professional committee signifies a new phase in the standardization of clinical practices, academic exchanges, and research collaboration in tumor immunotherapy within Jiangsu Province [6]. - The integration of immunotherapy with traditional treatments like surgery, radiotherapy, and chemotherapy represents a paradigm shift towards comprehensive cancer care, aiming to improve patient survival and quality of life [6].