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癌症中的非常规免疫治疗:机遇与挑战

英文原题:Unconventional Immunotherapies in Cancer: Opportunities and Challenges.

查看英文原题

Unconventional Immunotherapies in Cancer: Opportunities and Challenges.

PubMed 2025/08/04(内容时间) Pharmaceuticals (Basel) Q1 · IF 5.7(JCR 2025)

研究概要

包括免疫检查点阻断和嵌合抗原受体(CAR)-T 细胞在内的常规免疫治疗,在过去十年中彻底改变了癌症治疗。

中文摘要

过去十年,免疫检查点阻断和嵌合抗原受体(CAR)T细胞等传统免疫疗法彻底改变了癌症治疗。然而,这些疗法的疗效受到肿瘤耐药、抗原逃逸、细胞持久性不足和T细胞耗竭的限制,实体瘤治疗中尤为明显。新兴的非传统免疫疗法通过利用多样的免疫细胞亚群和合成生物制剂,带来了新机会。本综述探讨多种免疫疗法平台,包括γδ T细胞、不变型自然杀伤T细胞、黏膜相关不变型T细胞、工程化调节性T细胞和通用型CAR平台;还介绍双特异性及多特异性抗体、细胞因子融合蛋白、激动剂和溶瘤病毒等生物制剂,展示其模块化工程设计及现货型应用潜力。非传统平台的独特特点包括不依赖主要组织相容性复合体(MHC)、具有组织归巢能力、能够感知应激配体,以及可连接适应性免疫与先天免疫。它们与工程化策略兼容,有望成为可规模化、高效且经济的疗法。为应对功能异质性、免疫耗竭、肿瘤微环境介导的免疫抑制和细胞持久性不足等转化挑战,本文讨论代谢和表观遗传重编程、免疫伪装、基因编辑及利用人工智能进行患者分层等新策略。非传统免疫疗法拓展了癌症免疫治疗的前景,有望突破实体瘤治疗的障碍并提升可及性。持续投入机制研究和可规模化生产,是充分释放其临床潜力的关键。

展开英文摘要原文

Conventional immunotherapy, including immune checkpoint blockade and chimeric antigen receptor (CAR)-T cells, has revolutionized cancer therapy over the past decade. Yet, the efficacy of these therapies is limited by tumor resistance, antigen escape mechanisms, poor persistence, and T-cell exhaustion, particularly in the treatment of solid tumors. The emergence of unconventional immunotherapies offers novel opportunities by leveraging diverse immune cell subsets and synthetic biologics. This review explores various immunotherapy platforms, including gamma delta T cells, invariant natural killer T cells, mucosal-associated invariant T cells, engineered regulatory T cells, and universal CAR platforms. Additionally, it expands on biologics, including bispecific and multispecific antibodies, cytokine fusions, agonists, and oncolytic viruses, showcasing their potential for modular engineering and off-the-shelf applicability. Distinct features of unconventional platforms include independence from the major histocompatibility complex (MHC), tissue-homing capabilities, stress ligand sensing, and the ability to bridge adaptive and innate immunity. Their compatibility with engineering approaches highlights their potential as scalable, efficient, and cost-effective therapies. To overcome translational challenges such as functional heterogeneity, immune exhaustion, tumor microenvironment-mediated suppression, and limited persistence, novel strategies will be discussed, including metabolic and epigenetic reprogramming, immune cloaking, gene editing, and the utilization of artificial intelligence for patient stratification. Ultimately, unconventional immunotherapies extend the therapeutic horizon of cancer immunotherapy by breaking barriers in solid tumor treatment and increasing accessibility. Continued investments in research for mechanistic insights and scalable manufacturing are key to unlocking their full clinical potential.

论文信息

作者
Alturki M、Alshehri AA、Aldossary AM、Fallatah MM、Almughem FA、Al Fayez N、Majrashi MA、Alradwan IA
第一作者单位
Wellness and Preventative Medicine Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh 11442, Saudi Arabia.Saudi Arabia
通讯作者单位
Advanced Diagnostics and Therapeutics Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh 11442, Saudi Arabia.Saudi Arabia
文献类型
综述
期刊
Pharmaceuticals (Basel, Switzerland)2025 Aug 4
原文标识
PubMed 40872545 · DOI 10.3390/ph18081154