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白细胞介素-12/白细胞介素-2联合细胞因子疗法治疗实体瘤:从实验台到临床应用的转化

IL-12/IL-2 combination cytokine therapy for solid tumours: translation from bench to bedside.

作者信息

Wigginton Jon M, Wiltrout Robert H

机构信息

Investigational Biologics Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

出版信息

Expert Opin Biol Ther. 2002 Jun;2(5):513-24. doi: 10.1517/14712598.2.5.513.

Abstract

A broad range of approaches are under active investigation for the biological therapy of cancer, in particular, strategies directed at host immune response potentiation. These efforts have been fuelled by studies demonstrating the presence of an endogenous, but ineffective, host antitumour immune response and a greater understanding of the key factors which regulate this response. These mechanisms involve complex interactions between various effector cell populations, soluble factors and the tumour itself and are determined by the timing and relative intensity of positive and negative autoregulatory pathways, as well as a variety of immunosuppressive effects capable of mediating tumour self-defence. Based on these observations, immunotherapeutic regimens have been developed to potentiate antigen-specific sensitisation of effector cells with tumour vaccines/adjuvants, expand and amplify the number and function of effector cells, and to counteract suppressive pathways engaged by tumour cells themselves. Significant effort has focused on evaluating the use of exogenous cytokines, administered either systemically or locally into the tumour site via gene therapy. Several cytokines have demonstrated unique activity in the preclinical setting, including IL-2 and IFN-alpha -inducing cytokines such as IL12 and IL18. Most notably, later studies have now attempted to build on the clinical efficacy of IL-2 alone, to define combinations of agents with synergistic immunoregulatory and/or antitumour efficacy. Several lines of evidence suggest that IL-12 and IL-2 provide complementary immunoregulatory signals and have now shown that in combination, these two cytokines mediate synergistic antitumour activity in preclinical tumour models. This paper will review existing data regarding mechanisms of interaction between IL-2 and IL-12 in vitro and in preclinial models and describe future opportunities for the investigation of these potentially promising cytokines in the treatment of cancer.

摘要

目前正在积极研究多种用于癌症生物治疗的方法,尤其是旨在增强宿主免疫反应的策略。这些努力得益于多项研究,这些研究表明存在内源性但无效的宿主抗肿瘤免疫反应,并且对调节这种反应的关键因素有了更深入的了解。这些机制涉及各种效应细胞群体、可溶性因子与肿瘤本身之间的复杂相互作用,并由正负自调节途径的时间和相对强度以及多种能够介导肿瘤自我防御的免疫抑制作用所决定。基于这些观察结果,已经开发出免疫治疗方案,以增强效应细胞对肿瘤疫苗/佐剂的抗原特异性致敏作用,扩大和增强效应细胞的数量和功能,并抵消肿瘤细胞自身参与的抑制途径。大量努力集中于评估外源性细胞因子的使用,这些细胞因子可通过基因治疗全身给药或局部注射到肿瘤部位。几种细胞因子在临床前研究中已显示出独特的活性,包括IL-2和诱导IFN-α的细胞因子如IL12和IL18。最值得注意的是,后来的研究现在试图在单独使用IL-2的临床疗效基础上,确定具有协同免疫调节和/或抗肿瘤疗效的药物组合。多项证据表明,IL-12和IL-2提供互补的免疫调节信号,并且现已表明,在临床前肿瘤模型中,这两种细胞因子联合使用可介导协同抗肿瘤活性。本文将综述关于IL-2和IL-12在体外和临床前模型中相互作用机制的现有数据,并描述在癌症治疗中研究这些具有潜在前景的细胞因子的未来机会。

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