Cancer immunotherapy has transformed oncology, but lasting responses are still limited due to resistance mechanisms within the tumor microenvironment. MicroRNAs (miRNAs) have emerged as critical regulators of immune checkpoint pathways, antigen presentation, T-cell activity, and macrophage polarization. By modulating both tumor-intrinsic and immune cell–intrinsic processes, miRNAs influence the efficacy of immune checkpoint inhibitors, therapeutic vaccines, and adoptive cell therapies. Additionally, circulating and exosomal miRNAs are being investigated as minimally invasive biomarkers to predict patient response and resistance to immunotherapy. Clinical trials of miRNA-based treatments, including mimics and inhibitors, have highlighted both the promise and challenges of translating these molecules into clinical use. Advances in delivery systems, RNA chemistry, and combinatorial strategies are paving the way for their integration into precision immuno-oncology. This review offers a comprehensive overview of the mechanistic, biomarker, and therapeutic roles of miRNAs in cancer immunotherapy, highlighting ongoing clinical progress and prospects.
癌症免疫疗法已彻底改变肿瘤学领域，但由于肿瘤微环境中的耐药机制，持久性应答仍有限。微小RNA（miRNA）已成为免疫检查点通路、抗原呈递、T细胞活性和巨噬细胞极化的关键调控因子。通过同时调节肿瘤内在和免疫细胞内在过程，miRNA影响着免疫检查点抑制剂、治疗性疫苗及过继细胞疗法的疗效。此外，循环和外泌体miRNA正被研究作为微创生物标志物，以预测患者对免疫疗法的应答及耐药情况。基于miRNA的治疗（包括模拟物和抑制剂）的临床试验，既展现了这些分子转化为临床应用的潜力，也揭示了其面临的挑战。递送系统、RNA化学和联合策略的进步正为miRNA整合入精准免疫肿瘤学铺平道路。本综述全面概述了miRNA在癌症免疫疗法中的机制、生物标志物及治疗作用，并重点阐述了当前的临床进展与未来前景。
MicroRNAs Modulating Cancer Immunotherapy Mechanisms and Therapeutic Synergies
肿瘤(癌症)患者之家