下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:Top advances of the year in autologous cellular therapy in melanoma and solid tumors.
这些进展使自体细胞疗法成为黑色素瘤中不断演进的标准治疗,以及跨实体瘤的一种有前景的治疗模式,目前的工作重点在于提高可及性、克服耐药性和优化联合策略。
2025年在黑色素瘤和实体瘤自体细胞治疗领域取得了重大进展,建立在2024年具有里程碑意义的监管批准基础之上。Lifileucel是首个获美国食品药品监督管理局批准的用于晚期黑色素瘤的TIL(肿瘤浸润淋巴细胞)疗法,在C-144-01试验的5年分析中显示出持久疗效,客观缓解率(ORR)为31.4%,并在接受过大量既往治疗的人群中观察到持久缓解。真实世界数据进一步支持其有效性,较高的ORR可能反映了更早的治疗线数和患者选择差异。黑色素瘤优先表达抗原(PRAME)靶向的T细胞受体(TCR)T细胞疗法(anzu-cel,IMA203)在一项1期研究中显示出有前景的活性,在检查点抑制剂难治性黑色素瘤中ORR约为50%,缓解持久且毒性可控,验证了PRAME作为跨多种肿瘤类型的高价值靶点。下一代工程化TIL方法出现,以解决高剂量IL-2的局限性。OBX-115是一种IL-2非依赖性TIL平台,表达受乙酰唑胺调节的膜结合IL-15,在初始1期数据中显示出早期临床活性,ORR为67%。其他策略,包括CRISPR介导的基因编辑和检查点破坏,突显了向可编程、自我维持细胞疗法的转变。个体化新抗原疗法随着过继性T细胞平台和mRNA疫苗的早期临床验证而取得进展,在黑色素瘤中显示出免疫激活和改善的无复发生存期。最后,afamitresgene autoleucel(afami-cel)作为一种靶向 MAGE-A4 的 TCR-T 疗法,在滑膜肉瘤中显示出持久疗效,并在多种实体瘤中展现出不断扩展的活性,为 TCR-T 疗法确立了概念验证。总体而言,这些进展使自体细胞疗法成为黑色素瘤中不断演进的标准治疗,并成为一种在实体瘤中具有前景的治疗方式,目前正在进行的努力集中于提高可及性、克服耐药以及优化联合策略。
The year 2025 marked significant advances in autologous cellular therapy for melanoma and solid tumors, building on landmark regulatory approvals in 2024. Lifileucel, the first Food and Drug Administration-approved tumor-infiltrating lymphocyte (TIL) therapy for advanced melanoma, demonstrated durable efficacy in the 5-year analysis of the C-144-01 trial, with an objective response rate (ORR) of 31.4% and prolonged responses in a heavily pretreated population. Real world data further supported its effectiveness, with higher ORR likely reflecting earlier lines of therapy and differences in patient selection. Preferentially expressed antigen in melanoma (PRAME)-targeted T-cell receptor (TCR) T-cell therapy (anzu-cel, IMA203) showed promising activity in a phase 1 study, with ORR of approximately 50% in checkpoint inhibitor refractory melanoma, durable responses, and manageable toxicity, validating PRAME as a high value target across multiple tumor types. Next-generation engineered TIL approaches emerged to address limitations of high-dose IL-2. OBX-115, an IL-2 independent TIL platform expressing membrane-bound IL-15 regulated by acetazolamide, demonstrated early clinical activity with ORR of 67% in initial phase 1 data. Additional strategies, including CRISPR-mediated gene editing and checkpoint disruption, highlight a shift toward programmable, self-sustaining cellular therapies. Personalized neoantigen-based therapies advanced with early clinical validation of adoptive T-cell platforms and mRNA vaccines, demonstrating immune activation and improved recurrence-free survival in melanoma. Finally, afamitresgene autoleucel (afami-cel), a MAGE-A4 directed TCR-T therapy, showed durable efficacy in synovial sarcoma and expanding activity across solid tumors, establishing proof of concept for TCR-T approaches. Collectively, these advances position autologous cellular therapy as an evolving standard of care in melanoma and a promising modality across solid tumors, with ongoing efforts focused on improving accessibility, overcoming resistance, and optimizing combinatorial strategies.
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