Biological reaction regulator
It not only includes a large class of naturally generated biological substances, but also includes methods and means that can change the balance between host and tumor in vivo. Although the mechanism of action is diverse, it is no more than two major aspects, namely, killing or inhibiting tumors by interfering with the direct anti-tumor effect of cell growth, transformation or metastasis or by activating the effector cells of the immune system and their secreted factors.
There are the following types:
① Natural or recombinant cytokines. It includes interleukin, interferon (IFN), tumor necrosis factor (TNF), colony stimulating factor (CSF), etc.
② All kinds of anti-tumor somatic cells and auxiliary hematopoietic stem cells. Including bone marrow stem cells, peripheral blood and umbilical cord blood stem cells.
③ Antibodies. It includes various anti-tumor monoclonal antibodies, anti cell surface marker antibodies, etc.
④ Gene therapy.
⑤ Tumor vaccine.
⑥ Anti angiogenesis.
⑦ Cell differentiation inducer.
⑧ Enzyme preparations and enzyme inhibitors.
⑨ Some fungi and their active ingredients.
Such as Bacillus Calmette Guerin (BCG), Corynebacterium parvum (CP), Streptococcus (OK432), Pseudomonas Jinan, etc. ⑩ Plant medicine. Such as lentinan, coriolus versicolor polysaccharide, astragalus polysaccharide, acanthopanax senticosus polysaccharide, fuzheng ligustrum lucidum LL-E, lycium barbarum polysaccharide, epimedium polysaccharide, phytolacca polysaccharide, total saponins of ginseng flowers, cordyceps sinensis, etc.
treatment
There are several ways. The most widely used and effective class of biological response regulators of cytokines are interferon (IFN), interleukin (Interleukin), etc.
① The treatment of interferon is shown in the table below. Dose and effective disease of interferon α Tumor scheme and dose efficiency (mean)% Blood tumor Hair cell leukemia 3MU/(m2 · day) 70 ～ 90 (80) Chronic myeloid leukemia 5MU/(m2 · day) 45 ～ 85 (58) Lymphocytic lymphoma (low grade) 3 ～ 50MU/(m2 · day or the next day) 27 ～ 85 (48) Multiple myeloma 5 ～ 12MU/(m2 · day or the next day) 3 ～ 18 (15) Solid tumor Malignant melanoma 5 ～ 20MU/(m2 · day or the next day) 7 ～ 19 (18) Renal cancer 5 ～ 20MU/(m2 · day or the next day) 8 ～ 23 (15) Kaposi's sarcoma 3 ～ 50MU/(m2 · day or the next day) 3 ～ 67 (30) Endocrine pancreatic tumor 3 ～ 5MU/(m2 · day or the next day) 33 ～ 77 (50) type cancer 12 ～ 24MU/(m2 · day or the next day) 20 ～ 40 (20) Note: MU means millions of units.
② Interleukin. There are more than ten kinds, of which interleukin - Ⅱ (IL − 2) is the most deeply studied and widely used. In December 1985, the New England Journal of Medicine of the National Cancer Institute of the United States reported for the first time that 25 patients with advanced melanoma and renal cancer were treated with large doses of interleukin - Ⅱ LAK cells (lymphokine activated killer cells), and the effective rate was 44%.
③ Hematopoietic growth factors. More than 25 cytokines have been proved to affect hematopoietic activity. Granulocyte growth factor (G – CSF), granulocyte macrophage growth factor (GM – CSF) and erythropoietin (EPO) are commonly used in most countries.
Adoptive cellular immunotherapy
Since the early 1980s, the characteristics of LAK cells have been extensively studied. It is a group of cytolytic population different from natural killer cells (NK cells) or specific cytotoxic T lymphocytes (CTL). LAK cells were collected from peripheral blood lymphocytes when the patient started interleukin - Ⅱ treatment for a few days after the rebound proliferation. After several days of culture with interleukin - Ⅱ in vitro, it develops into highly non-specific cytotoxic cells and then is retransmitted to patients. TILs cells are T lymphocytes directly isolated from tumor tissue, which are induced by interleukin-II after in vitro culture. It has tumor specific killing activity, especially for melanoma.
Tumor vaccine
Influenced by vaccines in the treatment of infectious diseases, tumor vaccines began to be used clinically in the early 20th century. The purpose of active immunotherapy with tumor vaccine is to overcome the immunosuppression caused by tumor products; Stimulate specific immunity to attack tumor cells; Enhance the immunogenicity of tumor associated antigen (TAA).
monoclonal antibody
Until the end of 1997, the United States approved Rituxan for clinical anti-tumor treatment. It is a monoclonal antibody against CD20 on the surface of B cells. The effective rate for recurrent and chemotherapy resistant non Hodgkin's lymphoma was 48%. In combination with chemotherapy drugs, the effective rate for advanced non Hodgkin's lymphoma can reach 98%. In September 1998, the United States approved another monoclonal antibody Herceptin for tumor treatment. Its target is tumor cells with HER2 gene overexpression. It has been observed that in 1/3 women with weak breast cancer, the use of it increases the sensitivity of chemotherapy, improves the efficiency and prolongs the survival period. The role of biological therapy in the comprehensive treatment of tumors After the treatment of some cellular immunotherapy and cytokines such as interleukin - Ⅱ, although the total effective rate is not high, the remission period of the effective patients is far more than that of chemotherapy and radiotherapy for similar diseases. When the number of tumor cells in mice is 106, the host has the ability to compete with it. When this number is converted to human body, it should be 3.5 × 109 cancer cells, equivalent to a spherical nodule with a diameter of 1.5 cm. That is to say, as long as the tumor load is pulled below 109 by various means and the ability of the body to fight against it is restored at the same time, it is expected to coexist with the tumor for a long time and achieve the goal of curing the tumor. [1]
