帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
英文原题:Magnetotactic bacterial-reprogrammed TCR-macrophages for durable anti-tumor photoimmune therapy.
巨噬细胞在头颈癌(HNC)的临床治疗中展现出巨大潜力。
巨噬细胞在头颈癌(HNC)的临床治疗中展现出巨大前景。然而,由于缺乏肿瘤特异性靶点和肿瘤耐药性,巨噬细胞疗法面临重大障碍。在此,我们报道了一种磁趋化细菌重编程T细胞受体巨噬细胞(TCR-M)的开发,该细胞将人乳头瘤病毒(HPV)相关HNC特异性靶向与巨噬细胞固有浸润能力相结合,能够对头颈部鳞状细胞癌(HNSCC)产生强效免疫细胞毒性。通过内化磁趋化细菌AMB-1,TCR-M组合实现了肿瘤特异性靶向和可控磁响应,从而激发持久的抗肿瘤光免疫反应。值得注意的是,AMB-1的掺入赋予巨噬细胞磁导航能力和激光响应性极化,形成Bac@TCR-M + L,其获得M1表型并具有持续的抗肿瘤光免疫反应。在磁驱动下,Bac@TCR-M + L与未处理的TCR-M相比,在肿瘤部位的积聚显著增强,同时伴有TNF-α和IFN-γ分泌升高以及活性氧(ROS)产生增加。此外,Bac@TCR-M + L将肿瘤相关巨噬细胞(TAMs)再教育为抗肿瘤M1表型,实现协同肿瘤杀伤。我们的研究结果确立了Bac@TCR-M + L作为一种范式转变的巨噬细胞疗法,其整合了微生物工程、机器人控制和细胞治疗,在HNC治疗中产生持久的抗肿瘤效果,并为克服癌症耐药性开辟了新途径。
Macrophage have shown great promise in the clinical treatment for head and neck cancer (HNC). However, macrophage therapies confront significant hurdles due to a deficiency of tumor-specific targets and tumor resistance. Herein, we report the development of a magnetotactic bacterial-reprogrammed T-cell receptor macrophage (TCR-M) that integrates human papillomavirus (HPV) associated HNC specific targeting with innate macrophage infiltration capacity, enabling potent immune cytotoxicity against head and neck squamous cell carcinoma (HNSCC). By internalizing magnetotactic bacteria AMB-1, the TCR-M combination achieves tumor-specific targeting and controllable magnetic responsiveness to elicit durable anti-tumor photoimmune response. Notably, AMB-1 incorporation endows macrophages with magnetic navigation capability and laser-responsive polarization into Bac@TCR-M + L, which acquires M1 phenotypes with sustained anti-tumor photoimmune response. Under magnetic actuation, Bac@TCR-M + L demonstrates significantly enhanced tumor site accumulation compared to untreated TCR-M, accompanied by elevated secretion of TNF-α and IFN-γ and augmented reactive oxygen species (ROS) production. Furthermore, Bac@TCR-M + L re-educates tumor-associated macrophages (TAMs) into anti-tumor M1 phenotypes, achieving collaborative tumor destruction. Our findings establish Bac@TCR-M + L as a paradigm-shifting macrophage therapy that integrates microbial engineering, robotic control, and cell therapy, yielding durable anti-tumor effects in HNC treatment and opening new avenues for overcoming cancer resistance.
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