借力推动前列腺癌 CAR-T 细胞治疗进展
Piggybacking toward Progress for CAR T-Cell Therapy in Prostate Cancer.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Synergistic potential of sipuleucel-T in enhancing immunotherapy for metastatic castration-resistant prostate cancer.
Synergistic potential of sipuleucel-T in enhancing immunotherapy for metastatic castration-resistant prostate cancer.
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转移性去势抵抗性前列腺癌(mCRPC)的免疫治疗临床试验在很大程度上未能取得成功,尽管临床前研究显示出良好前景,且在其他实体瘤中已证实有效。这些令人失望的临床结果被归因于免疫抑制性肿瘤微环境、浸润性免疫效应细胞相对缺乏,以及肿瘤相关和宿主相关因素,这些因素共同使前列腺癌成为一种相对免疫“冷”肿瘤。Sipuleucel-T(Provenge)是一种自体细胞免疫疗法,可诱导针对前列腺酸性磷酸酶的免疫反应。它于2010年获得美国食品药品监督管理局批准,成为首个在大型III期随机试验中显示mCRPC患者总生存期获益的免疫疗法。遗憾的是,后续基于免疫治疗的策略在mCRPC中相对于其他肿瘤类型疗效较差。鉴于sipuleucel-T作为标准治疗 backbone 的使用,将其与其他免疫疗法、激素疗法或化学疗法联合以提高其临床疗效的兴趣日益增加。本综述总结了将sipuleucel-T与其他治疗联合的既往经验和当前认识,并探讨了增强此类联合策略的未来方法。
Clinical trials of immunotherapy in metastatic castration-resistant prostate cancer (mCRPC) have largely been unsuccessful despite promising preclinical studies and proven efficacy in other solid tumors. These disappointing clinical outcomes have been attributed to an immunosuppressive tumor microenvironment, a relative lack of infiltrating immune effector cells, and tumor-related and host-related factors, which collectively render prostate cancer a relatively immunologically "cold" tumor. Sipuleucel-T (Provenge), an autologous cellular immunotherapy, induces an immune response targeted against prostatic acid phosphatase.
It received approval from the US Food and Drug Administration in 2010, marking the first immunotherapy to show an overall survival benefit in patients with mCRPC in large phase III randomized trials. Unfortunately, subsequent immunotherapy-based strategies have been less efficacious in mCRPC relative to other tumor types.
Given the use of sipuleucel-T as a standard of care backbone, there is emerging interest in combining it with other immunotherapies, hormonal therapies, or chemotherapies to improve its clinical efficacy. This review summarizes past experiences and current knowledge of combining sipuleucel-T with other treatments and explores future approaches to enhance such combinatorial strategies.
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