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评论:卵巢癌:通往有效治疗之路

英文原题:Commentary: Ovarian Cancer: Path to Effective Treatments.

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Commentary: Ovarian Cancer: Path to Effective Treatments.

PubMed 2025/01/01(内容时间) Crit Rev Immunol Q4 · IF 1.8(JCR 2025)

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中文摘要

尽管免疫检查点抑制剂和部分靶向治疗等癌症疗法有所进步,卵巢癌治疗仍未取得有效突破,因为这些疗法仅使部分患者获益,且保护作用持续时间较短。化疗和放疗可能导致免疫细胞耗竭和/或功能缺失。CAR-T 细胞疗法治疗多种血液系统癌症有效,但治疗实体瘤的成功有限。由于靶向抗原数量少,且治疗副作用显著,CAR-T 细胞用于实体瘤免疫治疗的疗效受到削弱,尽管全球对此类疗法的开发投入很大。近年来,双特异性和三特异性抗体被认为是有效癌症疗法,但目前也面临与CAR-T 类似的问题:肿瘤细胞抗原丢失会使这些疗法失效。当前应设计可协同杀伤或治疗肿瘤的疗法;要实现这一点,关键在于理解免疫疗法的作用机制。

因此,需要深化认识并制定有效策略,开发癌症免疫治疗方法。我们致力于理解自然杀伤(NK)细胞的免疫生物学。我们的重要发现之一是,NK细胞能够靶向主要组织相容性复合体I类表达较低的癌症干细胞样细胞(CSC)/分化不良肿瘤。

此外,我们发现,超强活化NK(sNK)细胞可有效靶向CSC/分化不良肿瘤及分化良好的卵巢肿瘤,而活化原代NK细胞仅靶向CSC/分化不良肿瘤。

因此,使用sNK细胞进行免疫治疗有望有效清除异质性卵巢肿瘤细胞群。

展开英文摘要原文

Despite advancements in cancer therapeutics such as checkpoint inhibitors and some targeted therapies, we have not achieved success in effectively treating ovarian cancer, since these therapeutics only benefit a subset of patients, and also provide short-term protection. The use of chemotherapy and radiation therapy can cause depletion and/or lack of immune cells' function.

Chimeric antigen receptor T (CAR-T) cell therapy is found to be effective against several blood-based cancers, but limited success was seen against solid tumors. Targeting fewer antigens and significant side effects of therapy decreases the efficacy of CAR-T cells as immunotherapeutic in solid tumors, even though there is a great drive and significant effort to establish these therapies around the world. Bispecific and tri-specific antibodies have recently been advocated as effective cancer therapeutics.

However, at present, these also suffer the fate of CAR-Ts since the loss of antigen on tumor cells will render these therapeutics ineffective. At present, we should design therapeutics that may have synergistic effects on killing/treating tumors. The only way we can establish that will be by learning the mechanisms of actions of immune therapeutics.

Thus, advancement in the knowledge and effective strategies are required to develop cancer immuno-therapeutics.

We have dedicated our efforts to understand the immunobiology of natural killer (NK) cells. One of our most important discoveries was demonstration of targeting of cancer stem-like cells (CSCs)/poorly differentiated tumors exhibiting lower major histocompability complex class I expression by the NK cells.

In addition, we showed that supercharged NK (sNK) cells had great ability to target both CSCs/poorly differentiated and well differentiated ovarian tumors, whereas activated primary NK cells only targeted CSCs/poorly differentiated tumors.

Therefore, the use of sNK cells in immunotherapy should result in effective elimination of heterogeneous populations of ovarian tumors.

论文信息

作者
Jewett A、Memarzadeh S、Kaur K
第一作者单位
Division of Oral Biology and Medicine, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, University of California School of Dentistry, 10833 Le Conte Ave, 90095 Los Angeles, CA, USA; The Jonsson Comprehensive Cancer Center, UCLA School of Dentistry and Medicine, Los Angeles, CA, USA.United States
通讯作者单位
Division of Oral Biology and Medicine, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, University of California School of Dentistry, 10833 Le Conte Ave, 90095 Los Angeles, CA, USA.United States
文献类型
综述
期刊
Critical reviews in immunology2025
原文标识
PubMed 39612280 · DOI 10.1615/CritRevImmunol.2024053766