← 返回前沿论文

实体瘤中 ICIs 与 TILs 联合治疗的当前进展和未来方向

英文原题:Current advances and future directions of combined ICIs and TILs in solid tumors.

PubMed 2025/11/13(内容时间) Cancer Lett Q1 · IF 11.8(JCR 2025)

研究概要

癌症中的免疫逃逸常由检查点分子介导,如程序性死亡-1(PD-1)、程序性死亡配体-1(PD-L1)和细胞毒性T淋巴细胞相关蛋白-4(CTLA-4),这些分子抑制T细胞识别并促进肿瘤进展。

中文摘要

癌症中的免疫逃逸通常由检查点分子介导,如程序性死亡-1(PD-1)、程序性死亡配体1(PD-L1)和细胞毒性T淋巴细胞相关蛋白-4(CTLA-4),这些分子抑制T细胞识别并促使肿瘤持续进展。为对抗这一免疫抑制轴,免疫检查点抑制剂(ICIs)被开发出来,通过逆转T淋巴细胞功能障碍来重新激活抗肿瘤免疫。已有超过30种ICIs被临床批准用于恶性肿瘤的治疗。尽管取得了这些进展,由于原发性或获得性耐药以及在以T细胞浸润不足为特征的免疫“冷”肿瘤微环境中疗效欠佳,ICI单药治疗仍受限。为应对这些挑战,将ICIs与TIL(肿瘤浸润淋巴细胞)治疗相结合的组合策略正日益受到关注。本综述综合了支持TIL-ICI在实体瘤中协同作用的临床前和临床证据,其中过继转移的肿瘤反应性T细胞增强瘤内免疫激活,而ICIs通过缓解检查点限制来维持TIL效应功能。我们进一步讨论了优化这一范式的新兴策略,包括具有增强持久性的工程化TIL、生物标志物驱动的患者分层,以及结合抗血管生成药物或表观遗传调节剂的多模式方案。尽管早期临床试验结果令人鼓舞,但临床采用的障碍仍然存在,如生产复杂性、免疫相关毒性管理以及III期验证的缺乏。通过阐明机制原理、当前进展和转化障碍,本工作为推进TIL-ICI组合走向更广泛的治疗实施提供了路线图。

展开英文摘要原文

Immune evasion in cancer is frequently mediated by checkpoint molecules such as programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte-associated protein-4 (CTLA-4), which suppress T-cell recognition and perpetuate tumor progression. To counter this immunosuppressive axis, immune checkpoint inhibitors (ICIs) have been developed to reinvigorate antitumor immunity by reversing T lymphocyte dysfunction. Over 30 ICIs have been clinically approved for the treatment of malignant tumors. Despite these advances, ICI monotherapy remains limited due to the primary or acquired resistance and suboptimal efficacy in immunologically "cold" tumor microenvironments characterized by inadequate T-cell infiltration. To address these challenges, combinatorial strategies integrating ICIs with tumor-infiltrating lymphocyte (TIL) therapy are gaining momentum. This review synthesizes preclinical and clinical evidences supporting TIL-ICI synergy in solid tumors, wherein adoptively transferred tumor-reactive T cells enhance intratumoral immune activation while ICIs sustain TIL effector functions by alleviating checkpoint constraints. We further discuss emerging strategies to optimize this paradigm, including engineered TILs with enhanced persistence, biomarker-driven patient stratification, and multimodal regimens incorporating anti-angiogenics or epigenetic modulators. Despite promising early-phase trial outcomes, barriers to clinical adoption still persist, such as manufacturing complexity, immune-related toxicity management, and the paucity of Phase III validation. By delineating mechanistic rationale, current progress, and translational roadblocks, this work provides a roadmap for advancing TIL-ICI combinations toward broader therapeutic implementation.

论文信息

作者
Wang Y、Ding Q、Wei J
第一作者单位
Department of Pharmacy, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, 210029, China; Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China.China
通讯作者单位
Department of Pharmacy, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, 210029, China. Electronic address: weijifu@njmu.edu.cn.China
文献类型
综述
期刊
Cancer letters2026 Jan 1
原文标识
PubMed 41241304 · DOI 10.1016/j.canlet.2025.218145