CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:New Emerging Targets in Cancer Immunotherapy: The Role of B7-H3.
New Emerging Targets in Cancer Immunotherapy: The Role of B7-H3.
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免疫检查点(IC)是通过共抑制或共刺激信号参与免疫应答精细调控的分子,其功能在于尽量减少宿主损伤。以多种治疗手段靶向IC,包括检查点抑制剂/单克隆抗体(mAb)、抗体药物偶联物(ADC)和CAR-T 细胞,已取得显著成果,尤其是在免疫原性肿瘤中,通过纳入这些IC靶向治疗,实现了癌症治疗的范式转变。
然而,相当大比例的患者对现有IC靶向方案出现原发性或继发性耐药,这要求进一步进展,使免疫治疗能够惠及更广泛的患者群体并延长缓解持续时间。B7-H3(B7同源物3蛋白,CD276)是B7家族IC蛋白的成员,在生理和病理环境中发挥多效性免疫调节作用。越来越多的证据表明,B7-H3在多种实体恶性肿瘤中异常表达,包括对当前免疫治疗选择不太敏感的肿瘤,并将其表达与晚期疾病、更差的患者生存和对基于IC方案的应答受损相关联。抗B7-H3药物,包括新型mAb、双特异性抗体、ADC、CAR-T 细胞和放射免疫治疗药物,在临床前模型中显示出令人鼓舞的抗肿瘤活性,并最近进入多种癌症类型的临床测试。在本综述中,我们简要介绍B7-H3的功能意义,并讨论关于其在实体恶性肿瘤中的预后意义和治疗潜力的最新证据,重点是目前在临床试验环境中评估的抗B7-H3手段。更深入地理解B7-H3在肿瘤微环境中复杂的相互作用,将拓展抗B7-H3药物的肿瘤学应用价值,并进一步塑造其在癌症治疗中的作用。
Immune checkpoints (ICs) are molecules implicated in the fine-tuning of immune response via co-inhibitory or co-stimulatory signals, and serve to secure minimized host damage. Targeting ICs with various therapeutic modalities, including checkpoint inhibitors/monoclonal antibodies (mAbs), antibody-drug conjugates (ADCs), and CAR-T cells has produced remarkable results, especially in immunogenic tumors, setting a paradigm shift in cancer therapeutics through the incorporation of these IC-targeted treatments.
However, the large proportion of subjects who experience primary or secondary resistance to available IC-targeted options necessitates further advancements that render immunotherapy beneficial for a larger patient pool with longer duration of response. B7-H3 (B7 Homolog 3 Protein, CD276) is a member of the B7 family of IC proteins that exerts pleiotropic immunomodulatory effects both in physiologic and pathologic contexts. Mounting evidence has demonstrated an aberrant expression of B7-H3 in various solid malignancies, including tumors less sensitive to current immunotherapeutic options, and has associated its expression with advanced disease, worse patient survival and impaired response to IC-based regimens.
Anti-B7-H3 agents, including novel mAbs, bispecific antibodies, ADCs, CAR-T cells, and radioimmunotherapy agents, have exhibited encouraging antitumor activity in preclinical models and have recently entered clinical testing for several cancer types.
In the present review, we concisely present the functional implications of B7-H3 and discuss the latest evidence regarding its prognostic significance and therapeutic potential in solid malignancies, with emphasis on anti-B7-H3 modalities that are currently evaluated in clinical trial settings. Better understanding of B7-H3 intricate interactions in the tumor microenvironment will expand the oncological utility of anti-B7-H3 agents and further shape their role in cancer therapeutics.
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