不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Resistance mechanisms of immune checkpoint inhibition in lymphoma: Focusing on the tumor microenvironment.
Resistance mechanisms of immune checkpoint inhibition in lymphoma: Focusing on the tumor microenvironment.
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免疫检查点抑制剂(ICIs)已经彻底改变了包括淋巴瘤在内的多种恶性肿瘤的治疗策略。然而,ICIs在不同淋巴瘤亚型中的疗效差异显著,只有少数患者能够实现持久缓解,因此需要揭示ICI耐药的潜在机制,以优化个体化方案并改善治疗结局。近年来,越来越多的证据已确定了ICI治疗的潜在预后因素,包括肿瘤突变负荷和肿瘤微环境(TME)。鉴于实体瘤与血液系统恶性肿瘤在TME方面的差异,我们在此综述ICIs治疗淋巴瘤的临床进展,并重点关注由TME诱导的耐药潜在机制,这些机制在淋巴瘤中发挥重要作用并显著影响其对ICIs的敏感性。特别是,我们强调TME中多种细胞群体(如TIL(肿瘤浸润淋巴细胞)、M2型肿瘤相关巨噬细胞和髓源性抑制细胞)和代谢物(如吲哚胺2,3-双加氧酶和腺苷)作为ICI应答预后生物标志物的价值,同时也强调免疫治疗中的其他潜在靶点,如EZH2、LAG-3、TIM-3、腺苷和PI3Kδ/γ。
Immune checkpoint inhibitors (ICIs) have revolutionized the therapeutic strategies of multiple types of malignancies including lymphoma.
However, efficiency of ICIs varies dramatically among different lymphoma subtypes, and durable response can only be achieved in a minority of patients, thus requiring unveiling the underlying mechanisms of ICI resistance to optimize the individualized regimens and improve the treatment outcomes. Recently, accumulating evidence has identified potential prognostic factors for ICI therapy, including tumor mutation burden and tumor microenvironment (TME).
Given the distinction between solid tumors and hematological malignancies in terms of TME, we here review the clinical updates of ICIs for lymphoma, and focus on the underlying mechanisms for resistance induced by TME, which play important roles in lymphoma and remarkably influence its sensitivity to ICIs. Particularly, we highlight the value of multiple cell populations (e.
g. , tumor infiltrating lymphocytes, M2 tumor-associated macrophages, and myeloid-derived suppressor cells) and metabolites (e. g. , indoleamine 2, 3-dioxygenase and adenosine) in the TME as prognostic biomarkers for ICI response, and also underline additional potential targets in immunotherapy, such as EZH2, LAG-3, TIM-3, adenosine, and PI3Kδ/γ.
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