膀胱癌免疫耐药机制及其克服策略的新进展
Recent Advances in Mechanisms of Immunotherapy Resistance in Bladder Cancer and Strategies to Overcome It
摘要: 膀胱癌作为泌尿系统中发病率较高的恶性肿瘤，近年来免疫治疗特别是免疫检查点抑制剂的应用取得了突破性进展，显著改善了患者的预后。然而，免疫耐药的出现成为限制其疗效的重要瓶颈，严重影响临床治疗效果和患者生存质量。本文围绕膀胱癌免疫耐药的复杂机制展开综述，重点分析肿瘤微环境中的免疫抑制因素、肿瘤细胞通过多种途径实现免疫逃逸以及免疫细胞功能的异常变化等关键环节。同时，系统评述了当前克服免疫耐药的多种策略，包括联合免疫治疗方案、新型免疫调节剂的研发以及精准免疫治疗的创新应用。通过整合最新的基础研究成果与临床试验数据，本文旨在深化对膀胱癌免疫耐药机制的理解，推动免疫治疗策略的优化与个体化发展，为提升患者治疗效果提供科学依据和实践指导。
Abstract: Bladder cancer is one of the most prevalent malignancies in the urinary system. In recent years, immunotherapy—particularly the use of immune checkpoint inhibitors—has achieved breakthrough progress and significantly improved patient outcomes. However, the emergence of immunotherapy resistance has become a major bottleneck limiting its therapeutic efficacy, thereby adversely affecting clinical outcomes and patients’ quality of life. This review focuses on the complex mechanisms underlying immunotherapy resistance in bladder cancer, with an emphasis on key aspects such as immunosuppressive factors within the tumor microenvironment, tumor cell–mediated immune evasion through multiple pathways, and dysfunction of immune cells. In addition, current strategies to overcome immunotherapy resistance are systematically summarized, including combination immunotherapy regimens, the development of novel immunomodulatory agents, and innovative applications of precision immunotherapy. By integrating the latest findings from basic research and clinical trials, this review aims to deepen the understanding of immunotherapy resistance mechanisms in bladder cancer, promote the optimization and personalization of immunotherapeutic strategies, and ultimately provide a scientific basis and practical guidance for improving patient outcomes.
文章引用：刘华, 刘建和. 膀胱癌免疫耐药机制及其克服策略的新进展[J]. 临床医学进展, 2026, 16(5): 2795-2807. https://doi.org/10.12677/acm.2026.1652091

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