肿瘤代谢重编程与免疫逃逸:机制、治疗策略及临床前景

何雨薇; 崔久嵬

doi:10.16689/j.cnki.cn11-9349/r.2026.04.001

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肿瘤代谢与营养电子杂志 ›› 2026, Vol. 13 ›› Issue (4) : 457-464. DOI: 10.16689/j.cnki.cn11-9349/r.2026.04.001

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肿瘤代谢重编程与免疫逃逸:机制、治疗策略及临床前景

何雨薇, 崔久嵬

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Metabolic reprogramming and immune evasion in cancer: mechanisms, therapeutic strategies, and clinical outlook

He Yuwei, Cui Jiuwei

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摘要

肿瘤微环境(TME)中复杂的代谢网络对恶性肿瘤细胞的增殖和侵袭发挥核心调控作用,并与浸润性免疫细胞的功能状态密切相关。肿瘤细胞通过代谢重编程重塑TME,造成缺氧、局部酸化、营养物质竞争耗竭、代谢废物聚积的环境,这一代谢失衡直接损伤浸润性免疫细胞的代谢能力和效应功能,借免疫细胞的代谢重塑更加强化TME的免疫抑制状态,从而推动肿瘤免疫逃逸。此外,TME代谢产物通过表观遗传修饰进行基因组的系统性重塑,加速T细胞耗竭并巩固TME的免疫抑制特点。通过靶向代谢通路为临床抗肿瘤治疗提供代谢干预策略目前已在探索中,但肿瘤的高度异质性、代谢通路多样性使治疗措施面临临床转化的巨大挑战。本文系统梳理了TME中代谢重编程驱动免疫逃逸的分子机制,总结代谢－表观遗传的免疫调控网络,并对现有的代谢靶向治疗方法进行综合阐述,为开发新型抗肿瘤免疫代谢治疗策略提供参考。

Abstract

The complex metabolic network in the tumor microenvironment (TME) plays a key role in controlling the growth and spread of malignant tumor cells, and it is closely linked to the function of infiltrating immune cells. Through metabolic reprogramming, tumor cells remodel the TME, leading to low oxygen, local acidity, nutrient depletion, and buildup of metabolic waste. This metabolic imbalance directly weakens the metabolic capacity and effector functions of infiltrating immune cells. In turn, the metabolic remodeling of immune cells further strengthens the immunosuppressive state of the TME, promoting tumor immune escape. Additionally, TME metabolites systematically reshape the genome through epigenetic modifications, speeding up T cell exhaustion and reinforcing the immunosuppressive features of the TME. Targeting metabolic pathways to provide metabolic intervention strategies for clinical anti-cancer therapy is currently under exploration. However, the high heterogeneity of tumors and the diversity of metabolic pathways present major challenges for translating these therapies into clinical practice. This review systematically outlines the molecular mechanisms by which metabolic reprogramming in the TME drives immune escape, summarizes the metabolic-epigenetic immune regulatory network, and provides a comprehensive overview of current metabolism-targeted therapeutic approaches, aiming to provide a reference for developing new anti-tumor immunometabolic strategies.

导出引用

何雨薇, 崔久嵬. 肿瘤代谢重编程与免疫逃逸:机制、治疗策略及临床前景[J]. 肿瘤代谢与营养电子杂志. 2026, 13(4): 457-464 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.04.001

He Yuwei, Cui Jiuwei. Metabolic reprogramming and immune evasion in cancer: mechanisms, therapeutic strategies, and clinical outlook[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(4): 457-464 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.04.001

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