Research background and project basis
Since entering the era of immunotherapy, most cancer patients have been able to benefit from the treatment of immune checkpoint inhibitors, but due to study design limitations, Some special groups such as the elderly, patients with autoimmune diseases, tuberculosis (TB) disease infection, poor general condition or Acquired immune deficiency syndrome (Acquired immune deficiency syndrome) Immunodeficiencysyndrome, AIDS) infection of tumor patients tend to be left out in the test the immune therapy clinical trials of new drugs. With the approval of multiple immune checkpoint inhibitors (ICIs) and the increasing affordability of ICIs, the safety and efficacy of ICls in this special population has received widespread attention. For example, in elderly patients, physiological aging of cells and tissues combined with environmental factors and chronic antigen exposure can lead to the remodeling of the immune system, with more differentiated cells and the accumulation of highly differentiated CD4+ and CD8+T cells in the aging immune system. Elderly patients have decreased tolerance to conventional chemotherapy and are more likely to have serious chemotherapy side effects, so chemotherapy should be carried out cautiously in elderly patients. Some studies have shown that the use of anti-PD-1 /PD-L1 immunotherapy is safer and more effective than chemotherapy. Secondly, for example, in patients with tumor complicated with HINV infection, with the application of immunohighly active combined antiretroviral therapy (HART), The incidence of non-AlDS-defining malignancies (NADM), where cancer has become the leading cause of death in HIV patients, is also on the rise and has even surpassed AIDS-defining malignancies. The increasing number of lung cancer patients with AIDS has also attracted more and more researchers’ attention. At the same time, several clinical studies preliminarily showed that immunotarget inhibitors (ICI) had different reports on efficacy and safety in different types of special populations, that is, immunotherapy may have great potential in patients with special populations. However, existing clinical studies have many problems, such as small sample size, no further exploration of the immune microenvironment and metabolomics of tumor cells in such patients, and it is still unclear whether the immune checkpoint pathway is active in the tumors of these patients. Therefore, we hope to carry out relevant research on immunotherapy for this population that cannot be ignored, in order to guide treatment and explore the purpose of mechanism.
Research purpose
To explore the characteristics of the immune microenvironment in the special population of immunotherapy, and to explore the baseline characteristics, anti-tumor efficacy and prognosis of the special population of immunotherapy