下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:The Role of Immunotherapy in the Management of Soft Tissue Sarcomas: Current Landscape and Future Outlook.
软组织肉瘤(STS)是肉瘤的一个亚类,肉瘤是一组罕见的、起源于间充质的异质性恶性肿瘤。
软组织肉瘤(STS)是肉瘤的一个亚类,肉瘤是一组罕见的、起源于间充质的异质性恶性肿瘤。目前的标准治疗包括手术切除,并联合全身化疗用于治疗高危局限性和转移性疾病。尽管传统上认为STS是免疫沉默型肿瘤,但STS与免疫系统相互作用,经历免疫编辑,从而改变肿瘤免疫原性和肿瘤微环境。近年来免疫检查点抑制的进展促成了探索免疫治疗在STS中疗效的临床试验。这些试验的结果指向免疫检查点阻断具有组织学亚型特异性的临床活性。此外,在STS的局部或全身治疗中加入免疫检查点抑制的联合策略进一步提高了其疗效。使用工程化T细胞受体方法的靶向免疫治疗也显示出作为部分STS患者治疗选择日益增加的前景。靶向NY-ESO-1和MAGE-A4的自体T细胞过继转移在表达这些抗原的肉瘤中具有高缓解率,尽管在缓解患者中常观察到复发。未来的工作必须集中于识别对这些治疗的原发性和获得性耐药机制,并将T细胞受体发现扩展到其他肿瘤相关抗原。
Soft tissue sarcomas (STS) are a subset of sarcoma, a rare group of heterogeneous malignancies of mesenchymal origin. Current standard of care involves surgical resection with systemic chemotherapy used to treat high-risk localized and metastatic disease. Though classically thought to be immunologically quiet tumors, STS interact with the immune system, undergoing immunoediting that alters tumor immunogenicity and the tumor microenvironment. Recent advances with immune checkpoint inhibition have led to clinical trials exploring the efficacy of immunotherapy in treating STS. Results from these trials point to histologic subtype-specific clinical activity of immune checkpoint blockade. In addition, combinatorial strategies adding immune checkpoint inhibition to local or systemic therapies for STS have further increased their efficacy. Targeted immunotherapies using engineered T-cell receptor-based approaches also show increasing promise as treatment options for some patients with STS. Adoptive transfer of autologous T cells targeting NY-ESO-1 and MAGE-A4 have high response rates in sarcomas expressing these antigens, although recurrence is often seen in responding patients. Future work must focus on identifying primary and acquired mechanisms of resistance to these therapies, and extend T-cell receptor discovery to other tumor-associated antigens.
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