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(2022-01-23 22:40):
#paper doi: 10.1038/s41573-021-00155-y. Nat Rev Drug Discov,2021 Mar 8. Beyond immune checkpoint blockade: emerging immunological strategies.
1. 推荐理由:肿瘤的免疫治疗近年来一直是肿瘤领域热门的研究课题;本篇综述整理总结了多项免疫治疗前沿研究成果,在免疫治疗机制探索,免疫治疗药物临床疗效等多个方面都有总结讨论,并提出了两个治疗创新应关注的关键因素;感兴趣的朋友不妨一读,科普当前肿瘤免疫治疗效果及研究进展,而关注该领域的朋友更可以从综述所提出的方向来结合自身研究课题进行梳理和深入挖掘;
2. 解读:当前免疫治疗的主力军还是免疫检查点抑制剂,其原理主要是通过“阻止”免疫抑制,持续激活免疫反应来达到“治疗”肿瘤的效果;而提高免疫治疗疗效应考虑到更为复杂的免疫细胞-癌细胞相互作用。作者提出以下两个改善方向:①改善T细胞归巢和功能障碍:②关注单核吞噬细胞功能用以TME炎症重塑;以上两个方向基于复杂的生物学机制又有多个影响因素,例如在T细胞归巢方向,有肿瘤微血管系统,趋化因子和细胞因子等;单核吞噬细胞方向,有CD47,血管生成,胞外基质等。
3. 评论:未来的免疫疗法需要更多的关注个性化或定制策略,这些策略不仅要考虑保护性免疫应答的机制,而且还考虑其他免疫细胞类型在TME复杂细胞网络中的作用;识别出肿瘤特异性的弱点,通过对应的调节药物影响,然后将这些新药物与检查点抑制剂结合,才有可能突破当前的困境。
Beyond immune checkpoint blockade: emerging immunological strategies
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Abstract:
The success of checkpoint inhibitors has accelerated the clinical implementation of a vast mosaic of single agents and combination immunotherapies. However, the lack of clinical translation for a number of immunotherapies as monotherapies or in combination with checkpoint inhibitors has clarified that new strategies must be employed to advance the field. The next chapter of immunotherapy should examine the immuno-oncology therapeutic failures, and consider the complexity of immune cell-cancer cell interactions to better design more effective anticancer drugs. Herein, we briefly review the history of immunotherapy and checkpoint blockade, highlighting important clinical failures. We discuss the critical aspects - beyond T cell co-receptors - of immune processes within the tumour microenvironment (TME) that may serve as avenues along which new therapeutic strategies in immuno-oncology can be forged. Emerging insights into tumour biology suggest that successful future therapeutics will focus on two key factors: rescuing T cell homing and dysfunction in the TME, and reappropriating mononuclear phagocyte function for TME inflammatory remodelling. New drugs will need to consider the complex cell networks that exist within tumours and among cancer types.
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