Testicular germ cell tumors (TGCTs) are cancers with very good prognosis, even in the metastatic setting, with high curative potential mainly attributed to the introduction of cisplatin-based chemotherapy. However, approximately 15% of the patients develop platinum-refractory disease and suffer multiple relapses. Therefore, there is an unmet need for novel therapeutic agents with improved efficacy and minimal long-term side effects. Recent advances in the development of immunotherapeutic agents, particularly immune checkpoint inhibitors (ICIs), have offered an opportunity to test their activity in various tumor types, including GCTs. This review aims to analyze the immune microenvironment of these tumors and present the most recently available data from studies that have tested immunotherapeutic agents against GCTs. The majority of the available knowledge derives from case reports or small cohort studies, particularly those involving ICIs of the PD-1/PD-L1 axis alone or in combination with anti-CTLA-4 monoclonal antibodies. Other immunotherapeutic targeted approaches, including antibody-drug conjugates, antibody prodrugs, vaccines, tyrosine kinase inhibitors, chimeric antigen receptor (CAR) T-cell therapy, have biological rationales and have shown preliminary activity or are currently being tested. Growing evidence on these and other approaches will assist in broadening the currently limited treatment armamentarium against platinum-refractory TGCTs.
睾丸生殖细胞肿瘤（TGCTs）是一种预后良好的癌症，即使在转移状态下也具有较高的治愈潜力，这主要归功于以顺铂为基础的化疗方案的引入。然而，约15%的患者会出现铂类耐药疾病并经历多次复发。因此，目前亟需开发疗效更佳且长期副作用最小化的新型治疗药物。免疫治疗药物，特别是免疫检查点抑制剂（ICIs）的研发进展，为测试其在包括GCTs在内的多种肿瘤类型中的活性提供了机会。本综述旨在分析这些肿瘤的免疫微环境，并呈现目前测试免疫治疗药物对GCTs疗效的最新研究数据。现有知识主要来源于病例报告或小规模队列研究，特别是涉及单独使用PD-1/PD-L1轴ICIs或联合抗CTLA-4单克隆抗体的研究。其他免疫治疗靶向方法，包括抗体药物偶联物、抗体前药、疫苗、酪氨酸激酶抑制剂、嵌合抗原受体（CAR）T细胞疗法，均具有生物学理论基础，并已显示出初步活性或正处于测试阶段。关于这些及其他方法的证据不断积累，将有助于拓宽目前针对铂类耐药TGCTs的有限治疗手段。
肿瘤(癌症)患者之家