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小细胞肺癌中 DLL3 导向治疗:从抗体偶联药物到精准免疫治疗与放射免疫治疗

英文原题:DLL3-guided therapies in small-cell lung cancer: from antibody-drug conjugate to precision immunotherapy and radioimmunotherapy.

PubMed 2024/05/10(内容时间) Mol Cancer Q1 · IF 42.2(JCR 2025)

研究概要

DLL3 作为一种抑制性配体下调 Notch 信号,并被 ASCL1 上调,而 ASCL1 是小细胞肺癌(SCLC)亚型 SCLC-A 中普遍存在的转录因子。

中文摘要

DLL3 是一种抑制性配体,可下调 Notch 信号,并受 ASCL1 上调;ASCL1 是小细胞肺癌(SCLC)亚型 SCLC-A 中常见的转录因子。目前靶向 DLL3 的治疗策略包括抗体药物偶联物(ADC)、双特异性 T 细胞衔接器(BiTE)和嵌合抗原受体(CAR)T 细胞疗法。尽管 rovalpituzumab tesirine(Rova-T)在 II 期研究中显示前景,但后续 III 期试验结果不佳,导致其停止开发。相反,靶向 DLL3 的 BiTE 引起了显著临床关注。例如,tarlatamab 在 II 期试验中较标准治疗提高应答率和无进展生存期,其生物制品许可申请(BLA)目前正由美国 FDA 审评。多项 III 期研究正在开展,以进一步评估 tarlatamab 临床疗效,同时也在开发新型 DLL3 靶向双特异性和三特异性 T 细胞衔接器。靶向 DLL3 的 CAR-T 疗法近期开始出现,正处于不同临床前和早期临床研究阶段。此外,临床前研究显示,DLL3 靶向放疗具有良好疗效,该方法将发射 α 粒子的治疗性放射性同位素与 DLL3 靶向抗体偶联。DLL3 靶向疗法在 SCLC 管理中具有很大潜力。未来临床试验将对比不同治疗方法结局,并探索联合疗法以改善患者生存,这至关重要。

展开英文摘要原文

DLL3 acts as an inhibitory ligand that downregulates Notch signaling and is upregulated by ASCL1, a transcription factor prevalent in the small-cell lung cancer (SCLC) subtype SCLC-A. Currently, the therapeutic strategies targeting DLL3 are varied, including antibody-drug conjugates (ADCs), bispecific T-cell engagers (BiTEs), and chimeric antigen receptor (CAR) T-cell therapies. Although rovalpituzumab tesirine (Rova-T) showed promise in a phase II study, it failed to produce favorable results in subsequent phase III trials, leading to the cessation of its development. Conversely, DLL3-targeted BiTEs have garnered significant clinical interest. Tarlatamab, for instance, demonstrated enhanced response rates and progression-free survival compared to the standard of care in a phase II trial; its biologics license application (BLA) is currently under US Food and Drug Administration (FDA) review. Numerous ongoing phase III studies aim to further evaluate tarlatamab's clinical efficacy, alongside the development of novel DLL3-targeted T-cell engagers, both bispecific and trispecific. CAR-T cell therapies targeting DLL3 have recently emerged and are undergoing various preclinical and early-phase clinical studies. Additionally, preclinical studies have shown promising efficacy for DLL3-targeted radiotherapy, which employs -particle-emitting therapeutic radioisotopes conjugated to DLL3-targeting antibodies. DLL3-targeted therapies hold substantial potential for SCLC management. Future clinical trials will be crucial for comparing treatment outcomes among various approaches and exploring combination therapies to improve patient survival outcomes.

论文信息

作者
Su PL、Chakravarthy K、Furuya N、Brownstein J、Yu J、Long M、Carbone D、Li Z
第一作者单位
Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 494 Biomedical Research Tower, 460 W 10th Ave., Columbus, OH, 43210, USA.United States
通讯作者单位
Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, 494 Biomedical Research Tower, 460 W 10th Ave., Columbus, OH, 43210, USA. kai.he@osumc.edu.United States
文献类型
综述 · 非美国政府资助研究 · 读者来信
期刊
Molecular cancer2024 May 10
原文标识
PubMed 38730427 · DOI 10.1186/s12943-024-02012-z