优化癌症免疫治疗的非药物干预措施。
Non-pharmaceutical interventions to optimize cancer immunotherapy.
发表日期:2023
作者:
Maximilian Boesch, Florent Baty, Frank Rassouli, Tobias Kowatsch, Markus Joerger, Martin Früh, Martin H Brutsche
来源:
OncoImmunology
摘要:
癌症患者作为弱者、需要最大限度休息和保护的传统形象开始消失。过多关注医疗方面以及个人自身的脆弱性和死亡率可能会适得其反,并且无法公正地对待人性的复杂性。与细胞毒性和淋巴细胞消耗治疗不同,免疫参与疗法可以增强免疫系统,通常对患者的危害较小。因此,接受检查点抑制剂的癌症患者本身并不被视为脆弱,至少在免疫学和身体方面如此。这篇观点文章提倡采用整体方法进行癌症免疫治疗,以患者为中心,重点关注个人资源并接受医疗保健专业人员的特定领域支持。它总结了有关非药物干预措施的最新证据,以增强免疫检查点阻断的功效并改善生活质量。这些干预措施针对行为因素,如饮食、体力活动、压力管理、检查点抑制剂输注的昼夜节律时间,以及放弃不必要的降低免疫治疗疗效的联合用药。非药物干预措施普遍可及、广泛适用、可立即采取行动、可扩展且经济上可持续,为所有相关利益相关者创造价值。最重要的是,这个整体框架重新强调患者作为一个整体,并充分利用抗癌免疫和检查点封锁的潜力,有可能带来生存获益。建议数字疗法陪伴患者完成改变生活方式相关行为的使命,为治疗效果和个人成长创造最佳条件。© 2023 作者。经泰勒许可出版
The traditional picture of cancer patients as weak individuals requiring maximum rest and protection is beginning to dissolve. Too much focus on the medical side and one's own vulnerability and mortality might be counterproductive and not doing justice to the complexity of human nature. Unlike cytotoxic and lympho-depleting treatments, immune-engaging therapies strengthen the immune system and are typically less harmful for patients. Thus, cancer patients receiving checkpoint inhibitors are not viewed as being vulnerable per se, at least not in immunological and physical terms. This perspective article advocates a holistic approach to cancer immunotherapy, with an empowered patient in the center, focusing on personal resources and receiving domain-specific support from healthcare professionals. It summarizes recent evidence on non-pharmaceutical interventions to enhance the efficacy of immune checkpoint blockade and improve quality of life. These interventions target behavioral factors such as diet, physical activity, stress management, circadian timing of checkpoint inhibitor infusion, and waiving unnecessary co-medication curtailing immunotherapy efficacy. Non-pharmaceutical interventions are universally accessible, broadly applicable, instantly actionable, scalable, and economically sustainable, creating value for all stakeholders involved. Most importantly, this holistic framework re-emphasizes the patient as a whole and harnesses the full potential of anticancer immunity and checkpoint blockade, potentially leading to survival benefits. Digital therapeutics are proposed to accompany the patients on their mission toward change in lifestyle-related behaviors for creating optimal conditions for treatment efficacy and personal growth.© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.