免疫检查点抑制剂的上市为肿瘤患者带来了新的希望。 但是部分患者对免疫检查点抑制剂无应答或产生耐药,因 此如何提高免疫检查点抑制剂的疗效迫在眉睫。 运动可以降低患癌风险,提高肿瘤患者的生存率,甚至增强肿瘤治疗的疗 效,但是运动时免疫变化的机制十分复杂,因此运动如何影响免疫检查点抑制剂的疗效仍不确定。 目前,已经有研究对接受 免疫检查点抑制剂治疗的荷瘤小鼠或肿瘤患者进行运动干预,并探究其抗肿瘤免疫系统以及肿瘤微环境变化的潜在机制,这 些临床前和临床试验结果表明,运动可能改善肿瘤患者的抗肿瘤免疫系统和肿瘤微环境。 运动旨在诱导免疫细胞动员和再 分布、免疫刺激肌因子的释放、免疫细胞代谢的改变以及改善免疫衰老来发挥抗肿瘤作用。 “热肿瘤”具有抗肿瘤潜力的免疫 细胞的肿瘤微环境,其可能提高患者免疫检查点抑制剂治疗的应答率,改善患者的生存预后,增强冷肿瘤(缺乏效应免疫细胞 的肿瘤微环境)患者的免疫检查点抑制剂疗效。 运动主要通过效应 T 细胞浸润、髓源性抑制细胞耗竭、抗肿瘤肌因子分泌和 肿瘤脉管系统正常化促使热肿瘤的产生或重新编程冷肿瘤,然而关于这方面的临床研究还需进一步推进。 本综述旨在对运 动和免疫检查点抑制剂联合治疗的发展以及潜在机制方面进行讨论。

The introduction of immune checkpoint inhibitors has brought new hope to cancer patients. However some patients do not respond to or develop resistance to immune checkpoint inhibitors so how to improve the efficacy of immune checkpoint inhibitors is imminent. It is well known that exercise can reduce the risk of cancer improve the survival rate of cancer patients and even enhance the efficacy of cancer treatment. However the mechanism of immune changes during exercise is very complex so how exercise affects the efficacy of immune checkpoint inhibitors is still uncertain. To date studies have been conducted to investigate the impact of exercise on hormonal mice or cancer patients treated with immune checkpoint inhibitors. These studies have sought to elucidate the potential mechanisms underlying alterations in the anti-tumor immune system and the tumor microenvironment. The findings from these preclinical and clinical trials indicate that exercise may enhance the anti-tumor immune system and the tumor microenvironment in cancer patients. The objective of exercise is to induce mobilization and redistribution of immune cells the release of immunostimulatory myokines alterations in immune cell metabolism and the amelioration of immune senescence in order to exert antitumor effects. The presence of hot tumors may enhance the efficacy of immune checkpoint inhibitor therapy in patients improve their survival prognosis and facilitate the response rate of cold tumors to immune checkpoint inhibitors. The generation of hot tumors or reprogramming of cold tumors is primarily facilitated by exercise through effector T-cell infiltration myeloid-derived suppressor cell depletion anti-tumor myofactor secretion and normalization of the tumor vasculature system. However further advancement of clinical studies on this topic is necessary. This review aims to discuss the development and potential mechanistic aspects of combination therapy of exercise and immune checkpoint inhibitors.