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5ep9lzv 发表于 2024-5-21 02:58:46

癌症疫苗2030年前或将面世！寓意着癌症将被处理了？

    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/oHf4BXeKAg1w5VyWPAFf71m7J56r3vTC21GOnyDuFTHvjfJu1CSBfUBy58LIEqltibb2UibRibQm1GMFw7E8vuBEQ/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">导读</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">“癌症疫苗”能预防癌症吗？</span></p><span style="color: black;"><strong style="color: blue;"><span style="color: black;">源自</span>：医脉通</strong></span><span style="color: black;"><strong style="color: blue;">作者：晗寒</strong></span><span style="color: black;"><strong style="color: blue;">本文为医脉通编辑撰写，未经授权请勿转载。</strong></span><img src="https://mmbiz.qpic.cn/mmbiz_gif/oHf4BXeKAg0icibNnlrPHnU0Fn2aCxXfM0WHakbSRicbmwgMUiav4F6604ISoPNiacvnw1uSKK7b3aVVeoLhuQcibkxg/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;">
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">前几日，一条“癌症疫苗2030年前或将<span style="color: black;">面世</span>”的<span style="color: black;">博客</span>引爆了热点。</p>

    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">近年来，<span style="color: black;">因为</span>不健康的生活习惯、<span style="color: black;">膳食</span>、人口老龄化等多种<span style="color: black;">原因</span>影响，世界范围内癌症<span style="color: black;">出现</span>率<span style="color: black;">持续</span><span style="color: black;">上升</span>，而<span style="color: black;">病人</span>年龄却<span style="color: black;">逐步</span>降低。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">GLOBOCAN 2020于2020年12月<span style="color: black;">颁布</span>。<span style="color: black;">经过</span>对<span style="color: black;">全世界</span>185个国家/地区的36种癌症发病率、死亡率以及癌症发展趋势等<span style="color: black;">关联</span>数据进行统计，<span style="color: black;">发掘</span>2020年<span style="color: black;">全世界</span>共新发癌症19 292 789例，9 958 133例癌症<span style="color: black;">病人</span>死亡。其中，东亚地区男性及女性癌症发病率分别为242.3/10万、196.4/10万；死亡率分别为157.4/10万，93.0/10万。在这其中，<strong style="color: blue;">我国癌症新发及死亡病例分别占23.7%和30.2%，为<span style="color: black;">全世界</span>首位，属于“癌症大国”。</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">癌症治愈率低下，且<span style="color: black;">发展</span><span style="color: black;">快速</span>、易复发。在大<span style="color: black;">都数</span><span style="color: black;">病人</span>的观念里，得了癌症，就等于被宣判了死刑。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">而死亡<span style="color: black;">不仅</span>是癌症给人们带来的<span style="color: black;">独一</span>痛苦。癌症终末期<span style="color: black;">病人</span>身体机能几乎<span style="color: black;">已然</span>降至最低，<span style="color: black;">每日</span>都要忍受着极大的<span style="color: black;">熬煎</span>、<span style="color: black;">病痛</span>，<span style="color: black;">乃至</span>只求一死。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">这里</span>背景下被预言将要<span style="color: black;">显现</span>的“癌症疫苗”，<span style="color: black;">可否</span><span style="color: black;">寓意</span>着医学将在发展史上迈出巨大的一步，将要治愈<span style="color: black;">熬煎</span><span style="color: black;">没</span>数人的癌症？正如<span style="color: black;">初期</span>“牛痘”疫苗，<span style="color: black;">能够</span>有效防控住数个世纪内<span style="color: black;">导致</span>人类惶恐的<span style="color: black;">疾患</span>。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">对此，<span style="color: black;">没</span>数网友期待万分。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/oHf4BXeKAg1LFMaLHNo0j5nYlgB6cq3MeMgWuO5xjUm3jMY2vjLH70d3YiboySqlshcSQC1o0AWkM19TtNgWDxw/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">图源：网页截图</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">那样</span>，宣<span style="color: black;">叫作</span>“2030年前或将<span style="color: black;">面世</span>”的癌症疫苗，<span style="color: black;">到底</span>能否治愈癌症？</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">mRNA癌症疫苗侧重于治疗而非预防</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">乌古尔·萨欣（Uğur Şahin）、奥兹朗·图雷利（Özlem Türeci）<span style="color: black;">夫妇</span>是BioNTech 联合创始人。2020年3月，BioNTech 宣布美国辉瑞合作<span style="color: black;">开发</span>生产 mRNA 新冠疫苗。两位创始人在接受 BBC 采访时，<span style="color: black;">暗示</span>mRNA癌症疫苗的<span style="color: black;">科研</span><span style="color: black;">已然</span>取得了突破，这让<span style="color: black;">她们</span>对<span style="color: black;">将来</span>几年癌症疫苗上市持<span style="color: black;">阳光</span>态度。“可能会在2030 年之前上市。”</p>

    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">首要</span><span style="color: black;">咱们</span><span style="color: black;">必须</span><span style="color: black;">知道</span>一点，就<span style="color: black;">日前</span><span style="color: black;">科研</span>来看，<strong style="color: blue;">mRNA癌症疫苗更侧重于清除活动性<span style="color: black;">疾患</span>（癌细胞），而非预防。</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">咱们</span>熟知的预防性癌症疫苗<span style="color: black;">包含</span>HPV疫苗、乙肝疫苗等等，直接针对<span style="color: black;">导致</span>癌症的病毒，阻断病原体。此技术相对较为成熟，<span style="color: black;">能够</span>有效预防肝癌、宫颈癌等。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">不同于此，治疗性癌症疫苗<span style="color: black;">日前</span>仍然面临着<span style="color: black;">许多</span>挑战。大<span style="color: black;">都数</span>癌症病因<span style="color: black;">非常</span><span style="color: black;">繁杂</span>，并非某种特定病原体所<span style="color: black;">导致</span>，<span style="color: black;">没</span>法应用<span style="color: black;">药品</span>直接<span style="color: black;">控制</span>病原体；<span style="color: black;">另一</span>，肿瘤所存在的空间异质性、时间异质性，均使癌症治疗<span style="color: black;">非常</span>困难。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">但<span style="color: black;">咱们</span>对治愈癌症的探索从未停歇。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">日前</span><span style="color: black;">来讲</span>，治疗性癌症疫苗<span style="color: black;">包含</span>DNA疫苗、自体<span style="color: black;">病人</span>源性免疫细胞疫苗、表达肿瘤抗原的重组病毒疫苗等。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">如 Sipuleucel-T 疫苗，被用于治疗晚期前列腺癌<span style="color: black;">病人</span>，可使<span style="color: black;">病人</span><span style="color: black;">存活</span>期延长 2-4 个月。这款疫苗于 2010 年<span style="color: black;">得到</span>美国 FDA <span style="color: black;">准许</span>。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">卡介苗（BCG）<span style="color: black;">做为</span>治疗结核病的疫苗，<span style="color: black;">亦</span>可被用于<span style="color: black;">初期</span>膀胱癌的治疗。卡介苗在1990年<span style="color: black;">作为</span>美国 FDA <span style="color: black;">准许</span>的首个免疫疗法。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">有效的肿瘤疫苗疗法能够<span style="color: black;">帮忙</span><span style="color: black;">病人</span><span style="color: black;">创立</span>有效免疫<span style="color: black;">控制</span>屏障，以<span style="color: black;">控制</span>肿瘤细胞的免疫逃逸并杀死肿瘤细胞。<strong style="color: blue;">但受限于癌细胞免疫逃逸、抗原多样等<span style="color: black;">原因</span>，治疗性癌症疫苗<span style="color: black;">开发</span><span style="color: black;">状况</span>总体<span style="color: black;">不良</span>，尚未能够有效、<span style="color: black;">海量</span>投入临床。</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">而得益于近些年针对新冠病毒的mRNA疫苗<span style="color: black;">科研</span>，创始人图雷利认为mRNA新冠疫苗技术可用于<span style="color: black;">帮忙</span>摧毁癌细胞。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">mRNA新冠疫苗的工作原理为：将新冠病毒上不具感染性的刺突蛋白的遗传指令运送到人<span style="color: black;">身体</span>，让产生刺突蛋白的细胞接收，以此让免疫系统识别这种抗原。图雷利认为，<strong style="color: blue;"><span style="color: black;">能够</span>采取<span style="color: black;">一样</span>的<span style="color: black;">办法</span>让免疫系统寻找和摧毁癌细胞：即癌症疫苗<span style="color: black;">包括</span>有癌症抗原的遗传指令。</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">mRNA癌症疫苗早有<span style="color: black;">科研</span></strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">理论上<span style="color: black;">来讲</span>，不同于正常细胞的分化、凋亡，癌细胞<span style="color: black;">做为</span>变异细胞，能够<span style="color: black;">没</span>限增殖并进行转移、破坏正常的细胞组织。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对癌症的治疗性mRNA疫苗，其实早有<span style="color: black;">科研</span>。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1996年，首个mRNA癌症疫苗<span style="color: black;">科研</span>开展。该项<span style="color: black;">科研</span>的结果首次<span style="color: black;">显示</span>，RNA冲击的树突状细胞是<span style="color: black;">身体</span>外强效的抗原呈递细胞。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2022年ASCO年会上，BioNTech<span style="color: black;">机构</span>宣布，</span><strong style="color: blue;"><span style="color: black;">BNT122联合PD-L1<span style="color: black;">控制</span>剂阿替利珠单抗和mFOLFIRINOX化疗连用，在治疗接受手术切除的胰腺癌<span style="color: black;">病人</span>的I期临床<span style="color: black;">实验</span>中，<span style="color: black;">得到</span>积极结果。50%<span style="color: black;">病人</span>18个月后胰腺癌未复发，提示此治疗<span style="color: black;">办法</span>疗效及安全性均较好。</span></strong></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">除BioNTech外，另一家知名美mRNA疫苗<span style="color: black;">公司</span><span style="color: black;">亦</span>在布局mRNA癌症疫苗。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">Moderna预计<span style="color: black;">研发</span>一种个性化<span style="color: black;">精细</span>治疗癌症疫苗（PCV）mRNA-4157/V940。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2020年11月10日，</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">Moderna<span style="color: black;">机构</span><span style="color: black;">颁布</span>了mRNA-4157单药或与默沙东的PD-1<span style="color: black;">控制</span>剂帕博利珠单抗联合给药I期<span style="color: black;">实验</span>结果：在所有测试剂量下，均<span style="color: black;">拥有</span>良好的耐受性，并<span style="color: black;">诱发</span>了新抗原特异性T细胞反应。</span></strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">I期临床<span style="color: black;">实验</span>结果为：</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在切除黑色素瘤、结肠癌和肺癌等原发肿瘤后，接受mRNA-4157<span style="color: black;">做为</span>单药辅助治疗的13名<span style="color: black;">病人</span>中，11名<span style="color: black;">病人</span>在<span style="color: black;">科研</span>中保持<span style="color: black;">没</span>病状态长达75周。</p>在联合PD-1帕博利珠单抗治疗不可切除实体瘤的10名HPV(-)的头颈鳞状细胞癌<span style="color: black;">病人</span>和17名微卫星稳定型（MSS）结直肠癌<span style="color: black;">病人</span>中：有一半的HPV(-)的头颈鳞状细胞癌<span style="color: black;">病人</span>肿瘤缩小且2名<span style="color: black;">病人</span>肿瘤完全消失，<span style="color: black;">疾患</span><span style="color: black;">掌控</span>率高达90%，<span style="color: black;">无</span>报告与疫苗<span style="color: black;">关联</span>的严重不良事件；但在MSS结直肠癌中并<span style="color: black;">无</span>观察到肿瘤缩小，可能<span style="color: black;">因为</span>MSS结直肠癌属于“冷”肿瘤，肿瘤免疫微环境中缺少T细胞浸润。
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">这<span style="color: black;">寓意</span>着，mRNA疫苗与其他<span style="color: black;">药品</span>联合<span style="color: black;">运用</span>治疗特定癌症，<span style="color: black;">已然</span>取得了较好的<span style="color: black;">发展</span>。</span></strong></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">日前</span>，该项目<span style="color: black;">处在</span>临床<span style="color: black;">实验</span>II期，共招募了157例受试者，目的是<span style="color: black;">评定</span>完全切除后复发<span style="color: black;">危害</span>高的黑色素瘤<span style="color: black;">病人</span><span style="color: black;">可否</span>可<span style="color: black;">加强</span><span style="color: black;">没</span>复发<span style="color: black;">存活</span>率。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">《柳叶刀》子刊THE LANCET Oncology本月<span style="color: black;">发布</span>了关于mRNA癌症疫苗综述。其中谈及，<span style="color: black;">日前</span>在ClinicalTrials.gov注册的<span style="color: black;">关联</span>临床<span style="color: black;">科研</span>共有17个，治疗<span style="color: black;">行业</span><span style="color: black;">触及</span>肺癌、结直肠癌、胰腺癌、头颈部肿瘤、前列腺癌、三阴性乳腺癌、卵巢癌、黑色素瘤以及胶质母细胞瘤等。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">而相比其他类型疫苗，mRNA疫苗的<span style="color: black;">优良</span><span style="color: black;">包含</span><strong style="color: blue;">耐受性良好、易降解，<span style="color: black;">没</span>基因组整合<span style="color: black;">危害</span>、<span style="color: black;">没</span>传染性，具备<span style="color: black;">同期</span>诱导体液免疫和细胞介导性免疫的<span style="color: black;">潜能</span>；且可<span style="color: black;">有效</span>率、低成本、大规模生产。</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">但<span style="color: black;">日前</span><span style="color: black;">来讲</span>，mRNA疫苗治疗癌症仍然面临<span style="color: black;">许多</span>挑战。如<span style="color: black;">第1</span>步，<span style="color: black;">怎样</span>识别肿瘤特异性表位，仍然是一个<span style="color: black;">长时间</span><span style="color: black;">必须</span>探索的问题。其他还<span style="color: black;">包含</span>给药方式、治疗效果、<span style="color: black;">生效</span>时间、副<span style="color: black;">功效</span>等，<span style="color: black;">日前</span>都是未知数。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">但不论<span style="color: black;">怎样</span>，这些亟待探索的未知<span style="color: black;">行业</span>，还是在有效<span style="color: black;">保证</span>人类健康方面迈出了新的一步。癌症的治疗方式从<span style="color: black;">初期</span>仅依靠外科手术，<span style="color: black;">发展</span>到了<span style="color: black;">持有</span>化疗、放疗、靶向治疗等多种治疗方式……<span style="color: black;">亦</span>许总有一天，人类<span style="color: black;">亦</span>会战胜这看似“<span style="color: black;">没</span>解”的癌症。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考文献：</p>曹毛毛,陈万青.GLOBOCAN 2020<span style="color: black;">全世界</span>癌症统计数据<span style="color: black;">诠释</span>.中国医学前沿杂志(电子版),2021,13(03):63-69.

    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">杨海涛.mRNA肿瘤疫苗<span style="color: black;">开发</span>的挑战和前景展望.药学<span style="color: black;">发展</span>,2022,46(05):339-346.</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">Clinical advances and ongoing trials of mRNA vaccines for cancer treatment.The Lancet Oncology.VOLUME 23,ISSUE 10,E450-E458,OCTOBER 01,2022.doi.org/10.1016/S1470-2045(22)00372-2</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">Saha T, Dash C, Jayabalan R, Khiste S, Kulkarni A, Kurmi K, Mondal J, Majumder PK, Bardia A, Jang HL, Sengupta S. Intercellular nanotubes mediate mitochondrial trafficking between cancer and immune cells. Nat Nanotechnol. 2022 Jan;17(1):98-106. doi: 10.1038/s41565-021-01000-4. Epub 2021 Nov 18. PMID: 34795441.</span></p>
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dhfgh 发表于 2024-8-31 16:39:37

说得好啊！我在外链论坛打滚这么多年，所谓阅人无数，就算没有见过猪走路，也总明白猪肉是啥味道的。

7wu1wm0 发表于 2024-10-15 09:13:33

我完全同意你的看法，期待我们能深入探讨这个问题。

m5k1umn 发表于 2024-10-30 02:45:41

你的话深深触动了我，仿佛说出了我心里的声音。

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