免疫檢查點抑制劑療法在婦科惡性腫瘤的現況

Current Status of Immune Checkpoint Inhibitor Therapy in Gynecologic Malignancies

婦科惡性腫瘤主要包括子宮頸癌、子宮內膜癌及卵巢癌。子宮頸癌為全球女性第4大常見癌症，儘管人類乳突病毒疫苗逐漸普及，死亡負擔仍然顯著。在已開發國家子宮內膜癌已成為最常見的婦科癌症，且有年輕化趨勢。卵巢癌雖發生率較低，但因早期診斷困難，死亡率仍高。近年腫瘤免疫學迅速發展，確立免疫系統在癌症進程中的關鍵角色。免疫檢查點抑制劑透過解除T細胞抑制訊號，恢復抗腫瘤免疫反應。此抑制劑最初用於治療晚期疾病，並逐漸擴展至第一線治療、輔助治療、新輔助治療，以及與化療或標靶治療合併使用。在婦科腫瘤治療中，其臨床定位越來越清楚。未來將更聚焦於病人精準分層、最佳化合併策略以及副作用處置，以提升病人存活率與治療品質。

Gynecologic malignancies primarily include cervical cancer, endometrial cancer, and ovarian cancer. Cervical cancer is the fourth most common cancer among women worldwide. Despite the increasing implementation of human papillomavirus vaccination, the mortality burden remains substantial. Endometrial cancer has become the most common gynecologic malignancy in developed countries. The age of disease diagnosis is trending younger. Although ovarian cancer has a lower incidence, its mortality rate remains high due to difficulties in early diagnosis. In recent years, advances in tumor immunology have established the critical role of the immune system on cancer progression. Immune checkpoint inhibitors restore antitumor immunity by relieving inhibitory signals on T cells. These inhibitors were initially used to treat advanced, and have been gradually expanded to first-line treatment, adjuvant therapy, neoadjuvant setting, and combined use with chemotherapy or targeted therapy. In gynecologic cancers, their clinical role is becoming well-defined. Future efforts will further focus on precise patient stratification, optimized combination strategies, and management of adverse effects to improve patient survival and treatment quality.