传统上，肉瘤被认为是免疫安静的肿瘤，具有低肿瘤突变负荷 (TMB) 和免疫抑制肿瘤微环境 (TME)，包括 T 细胞浸润减少和 H1F1α、巨噬细胞和中性粒细胞水平升高。1,2 然而，研究表明研究表明，一部分肉瘤在免疫学上是“热”的，具有高 TMB、PDL-1 表达、CD8 T 细胞或存在三级淋巴结构 (TLS)，表明对免疫治疗敏感。3,4 在这里，我们回顾了免疫治疗的当前证据用于骨肉瘤 (BS) 和软组织肉瘤 (STS)，结合免疫检查点抑制剂 (ICI) 和过继性细胞疗法，包括工程 T 细胞疗法、嵌合抗原受体 (CAR) T 细胞疗法、肿瘤浸润淋巴细胞 (TIL)以及癌症疫苗和反应生物标志物。

Traditionally sarcomas have been considered immunologically quiet tumours, with low tumour mutational burden (TMB) and an immunosuppressive tumour microenvironment (TME), consisting of decreased T-cell infiltration and elevated levels of H1F1α, macrophages and neutrophils.1,2 However, research has shown that a subset of sarcomas are immunologically 'hot' with either high TMB, PDL-1 expression, CD8+ T cells or presence of tertiary lymphoid structures (TLS) demonstrating sensitivity to immunotherapy.3,4 Here, we review the current evidence for immunotherapy use in bone sarcomas (BS) and soft tissue sarcomas (STS), with immune checkpoint inhibitors (ICI) and adoptive cellular therapies including engineered T-cell therapies, chimeric antigen receptor (CAR) T-cell therapies, tumour infiltrating lymphocytes (TILs) and cancer vaccines and biomarkers of response.