肿瘤细胞治疗研究
英文原题：Update on immune-based therapy strategies targeting cancer stem cells.
Update on immune-based therapy strategies targeting cancer stem cells.
越来越多的数据表明，肿瘤中存在一种特殊的癌细胞亚群，称为肿瘤干细胞（CSCs），其负责恶性肿瘤的转移和复发，并具有自我更新、异质性和耐药能力等多种特性。
不断增加的证据表明，肿瘤中存在一类特殊细胞，称为癌症干细胞（CSC），可促进肿瘤转移和复发，并具有自我更新、异质性及耐药等特性。Notch、上皮-间质转化（EMT）、Hedgehog（Hh）和Wnt等信号通路或过程，以及CD44、CD123、CD133和上皮细胞黏附分子（EpCAM）等CSC表面标志物，在CSC特性的形成中发挥关键作用。因此，靶向CSC相关信号通路和表面标志物或有助于清除肿瘤。化疗和放疗等现有治疗无法根除所有CSC，患者短暂缓解后仍可能复发，因而有必要开发可与现有治疗联合的新型、更有效的疗法。免疫治疗是具有前景的CSC靶向策略。本文综述树突状细胞（DC）疫苗、嵌合抗原受体（CAR）工程化免疫细胞、自然杀伤（NK）细胞治疗、单克隆抗体、免疫检查点抑制剂及溶瘤病毒等策略在临床前和临床研究中的应用，重点讨论血液系统恶性肿瘤，并涉及实体瘤。
Accumulating data reveals that tumors possess a specialized subset of cancer cells named cancer stem cells (CSCs), responsible for metastasis and recurrence of malignancies, with various properties such as self-renewal, heterogenicity, and capacity for drug resistance. Some signaling pathways or processes like Notch, epithelial to mesenchymal transition (EMT), Hedgehog (Hh), and Wnt, as well as CSCs' surface markers such as CD44, CD123, CD133, and epithelial cell adhesion molecule (EpCAM) have pivotal roles in acquiring CSCs properties. Therefore, targeting CSC-related signaling pathways and surface markers might effectively eradicate tumors and pave the way for cancer survival. Since current treatments such as chemotherapy and radiation therapy cannot eradicate all of the CSCs and tumor relapse may happen following temporary recovery, improving novel and more efficient therapeutic options to combine with current treatments is required. Immunotherapy strategies are the new therapeutic modalities with promising results in targeting CSCs. Here, we review the targeting of CSCs by immunotherapy strategies such as dendritic cell (DC) vaccines, chimeric antigen receptors (CAR)-engineered immune cells, natural killer-cell (NK-cell) therapy, monoclonal antibodies (mAbs), checkpoint inhibitors, and the use of oncolytic viruses (OVs) in pre-clinical and clinical studies. This review will mainly focus on blood malignancies but also describe solid cancers.
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