Lichtor Terry, Glick Roberta P
Department of Neurological Surgery, Rush Medical College, Cook County Hospital, Hektoen Institute for Medical Research, Chicago, IL 60612, USA.
J Neurooncol. 2003 Dec;65(3):247-59. doi: 10.1023/b:neon.0000003654.83272.4a.
The prognosis for patients with an intracerebral (i.c.) neoplasm is poor. Conventional treatments such as surgery, radiation therapy and chemotherapy have done little to affect long-term survival, and new methods of treatment are urgently needed. In this report approaches involving cytokine gene therapy in treatment of malignant brain tumors are reviewed and contrasted to a strategy developed in this laboratory involving the use of allogeneic cells genetically modified to secrete cytokines. In our studies, mice with an i.c. glioma, melanoma or breast carcinoma treated solely by intratumoral injections with allogeneic cells genetically modified to secrete interleukin-2 (IL-2) were found to survive significantly longer than mice in various control groups. The anti-tumor response was mediated predominantly by T-cell subsets (CD8+ and NK/LAK cells). The injections resulted in the killing of only the neoplastic cells; non-neoplastic cells were unaffected. Experiments involving treatment of animals with i.c. tumor using subcutaneous injections of cytokine-secreting allogeneic cells in the presence of tumor antigens demonstrated no effect in prolonging survival in spite of the development of a vigorous systemic anti-tumor immune response. Of special interest, mice injected intracerebrally with the cytokine-secreting allogeneic cells alone exhibited no neurologic defect and there were no adverse effects on survival. The injection of cytokine-secreting allogeneic cells into the microenvironment of an i.c. tumor is hypothesized to induce an anti-tumor immune response capable of prolonging survival. This pre-clinical animal data directly translates into clinical treatments for patients with a malignant i.c. tumor.
脑内肿瘤患者的预后很差。手术、放疗和化疗等传统治疗方法对长期生存的影响甚微,因此迫切需要新的治疗方法。在本报告中,我们回顾了细胞因子基因治疗恶性脑肿瘤的方法,并将其与本实验室开发的一种策略进行了对比,该策略涉及使用经基因改造以分泌细胞因子的同种异体细胞。在我们的研究中,发现仅通过瘤内注射经基因改造以分泌白细胞介素-2(IL-2)的同种异体细胞治疗的脑内胶质瘤、黑色素瘤或乳腺癌小鼠的存活时间明显长于各个对照组的小鼠。抗肿瘤反应主要由T细胞亚群(CD8 +和NK/LAK细胞)介导。注射仅导致肿瘤细胞死亡;非肿瘤细胞未受影响。在肿瘤抗原存在下,使用皮下注射分泌细胞因子的同种异体细胞治疗脑内肿瘤动物的实验表明,尽管产生了强烈的全身抗肿瘤免疫反应,但对延长生存期没有效果。特别有趣的是,单独脑内注射分泌细胞因子的同种异体细胞的小鼠没有出现神经功能缺陷,对生存也没有不良影响。将分泌细胞因子的同种异体细胞注射到脑内肿瘤的微环境中被认为可诱导能够延长生存期的抗肿瘤免疫反应。这些临床前动物数据可直接转化为恶性脑内肿瘤患者的临床治疗方法。