中文摘要：

近年来，肿瘤免疫治疗取得重大突破性进展，以CAR T为代表的细胞免疫治疗在血液肿瘤的治疗中取得了令人鼓舞的临床疗效，免疫卡控点抑制剂CTLA 4和PD 1/PD L1单抗也相继获批用于临床。然而，大多数实体肿瘤患者并不能从免疫治疗中获益。本文从个体化新抗原表位的筛选、免疫细胞活力的维持、免疫细胞趋化与浸润、临床治疗模式和评价标准等方面总结了实体肿瘤免疫治疗难以见效的关键问题，并且从临床应用角度阐述其应对策略。

英文摘要：

In recent years, great breakthrough progresses have been achieved in cancer immunotherapy, cyto imunotherapy with CAR T as a representative has achieved encouraging clinical efficacy in the treatment of hematologic tumors, immune checkpoint inhibitor, CTLA 4 and PD 1/PD L1 monoclonal antibodies, have been approved for clinical use in one after another. However, most of the patients with solid tumors did not get benefit from the immunotherapy. This paper summarized key problems that were difficult to resolve in the immunotherapy of solid tumors from aspects of screening individual noval antigen epitopes, maintaining viability of the immune cells , chemotaxis and invasion of the immunocytes, clinical treatment model, evaluation criterion and so on. And their coping strategies were described from the angle of clinical application.