癌症免疫治疗学会(SITC)关于急性白血病免疫治疗的临床实践指南,2.0 版
Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of acute leukemia, version 2.0.
急性白血病是一种影响所有年龄段的血液系统恶性肿瘤。
英文原题:LILRB2 blockade facilitates macrophage repolarization and enhances T cell-mediated antitumor immunity.
这些发现支持 AZD2796 作为抗癌疗法的潜力,其能够与基于 T 细胞的治疗药物产生协同作用。
背景:免疫检查点抑制剂通过解除程序性死亡蛋白1(PD-1)等受体对T细胞的抑制,改变了实体瘤治疗并改善临床结局。尽管有所进展,持久抗肿瘤应答仍难以实现,常因肿瘤微环境(TME)中的其他免疫抑制机制所致。肿瘤相关巨噬细胞(TAM)对TME免疫抑制作用贡献显著,并在塑造T细胞介导的抗肿瘤应答中发挥关键作用。髓系细胞(包括TAM)表达的白细胞免疫球蛋白样受体亚家族B成员2(LILRB2)是一种抑制性受体,参与巨噬细胞介导的免疫抑制。本研究介绍高亲和力抗LILRB2抗体AZD2796,旨在使TAM由免疫抑制表型转向促炎表型。方法:采用单B细胞包裹的Immune Replica技术筛选抗LILRB2抗体。通过巨噬细胞刺激实验评估AZD2796增强CD40配体或脂多糖处理后巨噬细胞促炎应答的能力;建立肿瘤细胞/巨噬细胞/T细胞共培养实验,评估单独使用AZD2796或联合抗PD-1抗体对抗原特异性T细胞细胞溶解活性的影响。随后在CD34造血干细胞人源化小鼠中评估AZD2796改变肿瘤生长的能力。结果:临床前评估显示,AZD2796使巨噬细胞分化偏离免疫抑制表型并增强其促炎功能。AZD2796显著提高PD-1检查点阻断后的T细胞抗肿瘤应答;在小鼠人源化模型中,AZD2796单药也可减缓肿瘤生长。结论:这些结果支持AZD2796作为抗癌疗法的潜力,并提示其可与T细胞疗法协同。
BACKGROUND: Immune checkpoint inhibitors have revolutionized the treatment of solid tumors, enhancing clinical outcomes by releasing T cells from inhibitory effects of receptors like programmed cell death protein 1 (PD-1). Despite these advancements, achieving durable antitumor responses remains challenging, often due to additional immunosuppressive mechanisms within the tumor microenvironment (TME). Tumor-associated macrophages (TAMs) contribute significantly to the immunosuppressive TME and play a pivotal role in shaping T cell-mediated antitumor responses. Leukocyte immunoglobulin-like receptor subfamily B member 2 (LILRB2), expressed on myeloid cells, including TAMs, is an inhibitory receptor, which contributes to macrophage-mediated immunosuppression. In this study, we present AZD2796, a high-affinity anti-LILRB2 antibody designed to repolarize TAMs from an immunosuppressive to a proinflammatory phenotype. METHODS: Anti-LILRB2 antibodies were identified using single-B-cell encapsulation Immune Replica technology. The ability of AZD2796 to enhance proinflammatory responses from macrophages treated with CD40 ligand or lipopolysaccharide was assessed using a macrophage stimulation assay. A tumor cell/macrophage/T cell co-culture assay was developed to evaluate the effect of AZD2796, as a single agent and in combination with an anti-PD-1 antibody, on the cytolytic activity of antigen-specific T cells. In vivo assessments were then carried out to determine the ability of AZD2796 to alter tumor growth rate in mice humanized with CD34 hematopoietic stem cells. RESULTS: In preclinical assessments, AZD2796 skewed macrophage differentiation away from an immunosuppressive phenotype and enhanced the proinflammatory function of macrophages. AZD2796 significantly increased the anti-tumor response of T cells following PD-1 checkpoint blockade, while AZD2796 monotherapy reduced tumor growth in humanized mouse models. CONCLUSIONS: These findings support the potential of AZD2796 as an anti-cancer therapy, with the ability to synergize with T-cell-based therapeutics.
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