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迈向癌症免疫预防:治疗性疫苗的前景如何?

英文原题:Toward cancer immunoprevention: what are the prospects for therapeutic vaccines?

查看英文原题

Toward cancer immunoprevention: what are the prospects for therapeutic vaccines?

PubMed 2025/10/30(内容时间) Ann Med Surg (Lond) Q2 · IF 1.6(JCR 2025)

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中文摘要

治疗性癌症疫苗代表了一种有前景的免疫治疗方法,旨在通过刺激患者的免疫系统靶向肿瘤细胞来治疗已有癌症。与预防性疫苗不同,治疗性疫苗在癌症诊断后给药,重点在于诱导针对肿瘤相关抗原或肿瘤特异性新抗原的特异性细胞毒性 CD8 + T 细胞反应。这些抗原由抗原呈递细胞(如树突状细胞)呈递,以激活免疫攻击。

然而,治疗性疫苗的疗效往往受到免疫耐受、肿瘤异质性和免疫抑制性肿瘤微环境的限制,因此需要与免疫检查点抑制剂或化疗等其他治疗手段联合使用。目前正在研究多种疫苗平台,包括基于肽/蛋白的疫苗、基于 DNA/信使 RNA (mRNA) 的疫苗、树突状细胞疫苗、病毒载体疫苗,以及利用下一代测序进行精准靶向的个性化新抗原疫苗。临床试验针对多种癌症,包括黑色素瘤、妇科癌症、乳腺癌、胰腺癌、肝癌、胶质母细胞瘤和肺癌,结果显示免疫激活但临床疗效有限。关键挑战包括免疫逃逸、患者反应变异性、生产复杂性、高成本以及缺乏预测性生物标志物。目前正在探索纳米颗粒递送、强效佐剂、mRNA 平台和联合免疫治疗方面的技术进步,以增强疫苗性能。在资源匮乏的环境中,先进诊断和临床试验可及性有限等障碍要求制定量身定制的策略,以确保疫苗的公平部署。

总体而言,治疗性癌症疫苗有潜力被纳入标准肿瘤治疗方案,尤其是在辅助治疗和预防复发方面,重点在于个性化和可及的免疫疗法,以改变全球癌症管理格局。

展开英文摘要原文

Therapeutic cancer vaccines represent a promising immunotherapy approach aimed at treating existing cancers by stimulating the patient's immune system to target tumor cells. Unlike prophylactic vaccines, therapeutic vaccines are administered after cancer diagnosis and focus on inducing specific cytotoxic CD8 + T cell responses against tumor-associated antigens or tumor-specific neoantigens. These antigens are presented by antigen-presenting cells, such as dendritic cells, to activate an immune attack.

However, the efficacy of therapeutic vaccines is often limited by immune tolerance, tumor heterogeneity, and an immunosuppressive tumor microenvironment, necessitating combination with other treatments like immune checkpoint inhibitors or chemotherapy. Multiple vaccine platforms are under investigation, including peptide/protein-based, DNA/messenger RNA (mRNA)-based, dendritic cell vaccines, viral vector vaccines, and personalized neoantigen vaccines that leverage next-generation sequencing for precision targeting.

Clinical trials target a range of cancers, including melanoma, gynecologic, breast, pancreatic, liver, glioblastoma, and lung cancers, with results showing immune activation but modest clinical efficacy. Key challenges include immune evasion, variability in patient response, manufacturing complexities, high cost, and lack of predictive biomarkers.

Technological advances in nanoparticle delivery, potent adjuvants, mRNA platforms, and combination immunotherapies are being explored to enhance vaccine performance. In low-resource settings, barriers such as limited access to advanced diagnostics and clinical trials necessitate tailored strategies to ensure equitable vaccine deployment.

Overall, therapeutic cancer vaccines hold potential to become integrated into standard oncology protocols, especially for adjuvant therapy and recurrence prevention, with an emphasis on personalized and accessible immunotherapies to transform cancer management globally.

论文信息

作者
Tague C、Ekouo J、Makeda D、Yokolo H、Onesime J、Banga S、Kashafali A、Taj J
单位
Department of Research, Medical Research Circle (MedReC), Goma, DR Congo.
文献类型
社论
期刊
Annals of medicine and surgery (2012)2025 Dec
原文标识
PubMed 41377366 · DOI 10.1097/MS9.0000000000004234