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肿瘤对免疫治疗的耐药:全面认识与未来展望

英文原题:Cancer Resistance to Immunotherapy: Comprehensive Insights with Future Perspectives.

PubMed 2023/04/04(内容时间) Pharmaceutics Q1 · IF 6.9(JCR 2025)

研究概要

癌症免疫治疗是一种利用患者免疫系统力量的疗法,与传统化疗相比能更精准地靶向癌细胞。

中文摘要

癌症免疫疗法利用患者自身免疫系统,更精准地靶向癌细胞,与传统化疗相比具有不同作用方式。美国食品药品监督管理局(FDA)已批准多种免疫治疗,在黑色素瘤和小细胞肺癌等实体瘤中取得显著成功。此类疗法包括免疫检查点抑制剂、细胞因子和疫苗;嵌合抗原受体(CAR)T细胞治疗则在血液系统恶性肿瘤中显示出更好的应答。尽管取得突破,患者治疗应答仍存在差异;只有一小部分癌症患者获益,且疗效受肿瘤组织学类型及其他宿主因素影响。在这些情况下,癌细胞会发展出逃避免疫细胞识别和相互作用的机制,降低治疗效果。此类机制可能源自癌细胞内在因素,也可能由肿瘤微环境(TME)中的其他细胞造成。在治疗语境中,这一现象称为“免疫治疗耐药”:原发性耐药指治疗开始时即无应答,继发性耐药指免疫治疗初始应答后疾病复发。本文全面综述肿瘤免疫治疗耐药的内在和外在机制,并简要讨论多种免疫疗法及预防治疗后复发的近期进展,重点关注提高癌症患者免疫治疗疗效的新举措。

展开英文摘要原文

Cancer immunotherapy is a type of treatment that harnesses the power of the immune systems of patients to target cancer cells with better precision compared to traditional chemotherapy. Several lines of treatment have been approved by the US Food and Drug Administration (FDA) and have led to remarkable success in the treatment of solid tumors, such as melanoma and small-cell lung cancer. These immunotherapies include checkpoint inhibitors, cytokines, and vaccines, while the chimeric antigen receptor (CAR) T-cell treatment has shown better responses in hematological malignancies. Despite these breakthrough achievements, the response to treatment has been variable among patients, and only a small percentage of cancer patients gained from this treatment, depending on the histological type of tumor and other host factors. Cancer cells develop mechanisms to avoid interacting with immune cells in these circumstances, which has an adverse effect on how effectively they react to therapy. These mechanisms arise either due to intrinsic factors within cancer cells or due other cells within the tumor microenvironment (TME). When this scenario is used in a therapeutic setting, the term "resistance to immunotherapy" is applied; "primary resistance" denotes a failure to respond to treatment from the start, and "secondary resistance" denotes a relapse following the initial response to immunotherapy. Here, we provide a thorough summary of the internal and external mechanisms underlying tumor resistance to immunotherapy. Furthermore, a variety of immunotherapies are briefly discussed, along with recent developments that have been employed to prevent relapses following treatment, with a focus on upcoming initiatives to improve the efficacy of immunotherapy for cancer patients.

论文信息

作者
Said SS、Ibrahim WN
单位
Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar.
文献类型
综述
期刊
Pharmaceutics2023 Apr 4
原文标识
PubMed 37111629 · DOI 10.3390/pharmaceutics15041143