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血液系统恶性肿瘤中的免疫检查点阻断:现状与未来方向

英文原题:Immune Checkpoint Blockade in Hematological Malignancies: Current Status and Future Directions.

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Immune Checkpoint Blockade in Hematological Malignancies: Current Status and Future Directions.

PubMed 2026/01/31(内容时间) Cancers (Basel) Q2 · IF 4.8(JCR 2025)

研究概要

免疫检查点蛋白包括PD-1、CTLA-4、LAG-3、TIM-3和TIGIT,它们调节T细胞功能,而T细胞功能对于抗肿瘤免疫至关重要。

中文摘要

免疫检查点蛋白包括 PD-1、CTLA-4、LAG-3、TIM-3 和 TIGIT,它们调控 T 细胞功能,而 T 细胞功能对抗肿瘤免疫至关重要。这些免疫检查点蛋白的过表达会导致 T 细胞耗竭和抗肿瘤免疫的显著受损。使用免疫检查点抑制剂(ICI)恢复效应 T 细胞功能可重建抗肿瘤免疫,这转化为多种血液系统恶性肿瘤一线和挽救治疗中的临床疗效。ICI 的疗效在经典霍奇金淋巴瘤、原发纵隔大 B 细胞淋巴瘤和 NK/T 细胞淋巴瘤中最高,在免疫豁免部位淋巴瘤和皮肤 T 细胞淋巴瘤中中等。然而,在髓系恶性肿瘤和多发性骨髓瘤中,ICI 的疗效仍存疑问。除作为单药使用外,ICI 还与其他 ICI 联合使用;以及与化疗、抗体药物偶联物和表观遗传药物(组蛋白去乙酰化酶抑制剂和去甲基化药物)联合使用。更具创新性的策略包括在异基因造血干细胞移植和CAR-T 细胞治疗背景下使用 ICI。本综述综合了 ICI 在不同血液系统恶性肿瘤中应用的当前证据,并强调了向生物标志物驱动、合理设计的治疗组合发展的未来方向。

展开英文摘要原文

Immune checkpoint proteins including PD-1, CTLA-4, LAG-3, TIM-3, and TIGIT regulate T-cell functions, which are essential for anti-tumor immunity. Over-expression of these immune checkpoint proteins leads to T-cell exhaustion and a significant impairment of anti-tumor immunity. Rejuvenation of effector T-cell function with immune checkpoint inhibitors (ICI) restores anti-tumor immunity, which translates into clinical efficacy in the frontline and salvage treatment of various hematological malignancies. Efficacy of ICIs is highest in classical Hodgkin lymphoma, primary mediastinal large B-cell lymphoma, and NK/T-cell lymphomas, and modest in immune-privileged-site lymphomas and cutaneous T-cell lymphoma. However, in myeloid malignancies and multiple myeloma, the efficacy of ICIs remains doubtful. In addition to being used as single agents, ICIs have also been combined with other ICIs; as well as chemotherapy, antibody drug conjugates, and epigenetic agents (histone deacetylase inhibitors and hypomethylating agents). More innovative strategies include the use of ICIs in the context of allogeneic haematopoietic stem cell transplantation and chimeric antigen receptor T-cell therapy. This review synthesizes current evidence for the use of ICI in different haematological malignancies, and highlights future directions toward biomarker-driven, rationally designed therapeutic combinations.

论文信息

作者
Lau HC、Kwong YL
单位
Department of Medicine, Queen Mary Hospital, Hong Kong, China.Hong Kong
文献类型
综述
期刊
Cancers2026 Jan 31
原文标识
PubMed 41681956 · DOI 10.3390/cancers18030485