← 返回前沿论文

黑色素瘤细胞免疫治疗:癌症治疗的下一个前沿

英文原题:Cellular immunotherapy in melanoma: the next frontier in cancer treatment.

PubMed 2026/06/18(内容时间) J Exp Clin Cancer Res Q1 · IF 14.3(JCR 2025)

研究概要

尽管免疫检查点抑制剂和靶向治疗取得了进展,治疗耐药的黑色素瘤仍然是一个重大的临床挑战,因为大多数患者最终表现出原发性或获得性耐药,并在多个毒性治疗方案中进展,持久获益有限。

中文摘要

尽管免疫检查点抑制剂和靶向疗法不断进步,治疗耐药性黑色素瘤仍是重大临床挑战:多数患者最终出现原发性或获得性耐药,历经多线毒性治疗后疾病继续进展,持久获益有限。这种耐药不仅源于T细胞功能障碍,也与肿瘤反应性淋巴细胞数量显著不足有关,并受到髓系细胞及Treg介导的免疫抑制、抗原呈递受损和肿瘤去分化程序的共同影响,最终形成免疫“冷”微环境。细胞免疫疗法旨在补充或启动新的肿瘤反应性T细胞库,同时重塑肿瘤微环境并恢复持久免疫。树突状细胞疫苗可安全诱导广泛且持久的免疫应答,但在晚期疾病中单药活性有限。TIL(肿瘤浸润淋巴细胞)疗法直接补充缺失的肿瘤特异性细胞群,在免疫检查点抑制剂难治性黑色素瘤中显示出具有临床意义的缓解率,但制造流程复杂、耗时且需强化预处理。基因工程化TCR-T及CAR-T/CAR-NK疗法提供可编程特异性,但仍受到靶点选择、毒性风险及实体瘤中持久性有限等因素制约。NK细胞平台具备不依赖HLA及现货型治疗潜力,但仍需优化其迁移、持久性及抗免疫抑制能力。总体而言,合理的联合方案,特别是将树突状细胞启动与过继细胞治疗整合,是实现难治性黑色素瘤持久控制的最有前景途径。

展开英文摘要原文

Therapy-resistant melanoma remains a major clinical challenge despite advances with immune checkpoint inhibitors and targeted therapies, as most patients ultimately exhibit primary or acquired resistance and progress through multiple toxic treatment lines with limited durable benefit. This resistance reflects not only T-cell dysfunction but also a profound quantitative deficit of tumor-reactive lymphocytes, compounded by myeloid- and T reg -mediated immunosuppression, impaired antigen presentation, and tumor dedifferentiation programs generating a cold tumor microenvironment. Cellular immunotherapies aim to overcome these barriers by supplying or priming new tumor-reactive repertoires while reshaping the tumor microenvironment and restoring durable immunity. Dendritic-cell vaccines safely induce broad, long-lived responses but show modest activity as monotherapy in advanced disease. Tumor-infiltrating lymphocyte therapy directly replaces the missing tumor-specific compartment and has demonstrated clinically meaningful response rates in checkpoint-refractory melanoma, though at the cost of complex, intensive manufacturing and conditioning requirements. Genetically engineered TCR-T and CAR T/CAR NK therapies provide programmable specificity but remain constrained by antigen selection, toxicity risks, and limited persistence in solid tumors. NK-cell platforms offer HLA-independent, off-the-shelf potential but require further optimization for trafficking, persistence, and resistance to suppression. Overall, rational combinations - particularly DC-priming integrated with adoptive cell therapy - represent the most promising path to durable tumor control in treatment-refractory melanoma.

论文信息

作者
Wien AL、Stamtsis-Datsi A
第一作者单位
Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Gebäude 14.88 Moorenstr. 5, Düsseldorf, 40225, Germany.Germany
通讯作者单位
Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Gebäude 14.88 Moorenstr. 5, Düsseldorf, 40225, Germany. angeliki.stamtsis-datsi@med.uni-duesseldorf.de.Germany
文献类型
综述
期刊
Journal of experimental & clinical cancer research : CR2026 Jun 18
原文标识
PubMed 42316257 · DOI 10.1186/s13046-026-03762-y