下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:Treatment strategies for advanced synovial sarcoma: from chemotherapy to TCR-engineered T-cell therapy.
靶向 NY-ESO-1 和 MAGE-A4 的 TCR 工程化 T 细胞治疗已开展临床试验,多项试验报告的客观缓解率为 40-60%。
滑膜肉瘤(SS)是儿童和青少年中最常见的软组织肉瘤。尽管已有帕唑帕尼和曲贝替定等新药,复发后预后仍然不佳。过继细胞疗法是一种新兴治疗策略,通过在体外调节、操作和筛选自体 T 细胞,克服免疫系统对肿瘤细胞的耐受。癌睾抗原是特别有吸引力的免疫治疗靶点,因为男性生殖细胞缺乏人类白细胞抗原 I 类分子,限制了抗原呈递所触发的 T 细胞应答。靶向 NY-ESO-1 和 MAGE-A4 的 T 细胞受体(TCR)工程化 T 细胞疗法具有显著前景,因为这些抗原在肿瘤中高比例表达。该方法通过转移肿瘤抗原特异性 TCR α、β 链基因,利用转基因 TCR 重编程 T 淋巴细胞,有望为晚期 SS 患者带来治疗进展。已有靶向 NY-ESO-1 和 MAGE-A4 的 TCR 工程化 T 细胞疗法临床试验,多项试验报告客观缓解率为 40%–60%。这种有前景的疗效提示,对于晚期治疗选择有限的 SS,TCR 工程化 T 细胞疗法可能成为一种有吸引力的新型治疗方案。然而,若要在临床实践中使用该疗法,必须明确晚期 SS 患者在多柔比星为基础的化疗失败后的标准治疗路径。未来研究对于建立这一领域的治疗策略至关重要。
Synovial sarcoma (SS) is the most common soft tissue sarcoma in children and adolescents. Despite the availability of new agents such as pazopanib and trabectedin, the prognosis after recurrence remains poor. Adoptive cell therapy is an emerging therapeutic strategy based on the modulation, manipulation, and selection of autologous T-cells in vitro to overcome immune system tolerance to tumor cells. Cancer-testis antigens are particularly attractive targets for immune therapy because male germ cells lack human leukocyte antigen class I molecules, limiting T-cell responses triggered by antigen presentation. T-cell receptor (TCR) engineered T-cell therapy targeting NY-ESO-1 and MAGE-A4 holds significant promise because of the high positive expression of these antigens in tumors. This approach facilitates the reprogramming of T lymphocytes by a transgenic TCR through gene transfer of TCR and chains specific to tumor antigens, offering potential therapeutic advances for patients with advanced SS. Clinical trials of TCR-engineered T-cell therapy targeting NY-ESO-1 and MAGE-A4 have been conducted, with an objective response rate reported to be 40-60% across several trials. This promising efficacy suggests that TCR-engineered T-cell therapy could become an attractive novel therapeutic option for advanced SS, which has limited treatment options in later stages. However, if TCR-engineered T-cell therapy is to be used in clinical practice, the standard approach following the failure of doxorubicin-based chemotherapy in patients with advanced SS must be defined. Future studies will be critical for establishing treatment strategies in this field.
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