Mocellin Simone, Nitti Donato
Department of Oncological & Surgical Sciences, University of Padova, via Giustianiani 2, 35128 Padova, Italy.
Med Res Rev. 2008 May;28(3):413-44. doi: 10.1002/med.20110.
Despite the evidence that immune effectors can play a significant role in controlling tumor growth under natural conditions or in response to therapeutic manipulation, it is clear that malignant cells evade immune surveillance in most cases. Considering that anticancer vaccination has reached a plateau of results and currently no vaccination regimen is indicated as a standard anticancer therapy, the dissection of the molecular events underlying tumor immune escape is the necessary condition to make anticancer vaccines a therapeutic weapon effective enough to be implemented in the routine clinical setting. Recent years have witnessed significant advances in our understanding of the molecular mechanisms underlying tumor immune escape. These mechanistic insights are fostering the development of rationally designed therapeutics aimed at reverting the immunosuppressive circuits that undermine an effective antitumor immune response. In this review, the best characterized mechanisms that allow cancer cells to evade immune surveillance are overviewed and the most debated controversies constellating this complex field are highlighted. In addition, the latest therapeutic strategies devised to overcome tumor immune escape are described, with special regard to those entering clinical phase investigation.
尽管有证据表明免疫效应器在自然条件下或对治疗性操作作出反应时可在控制肿瘤生长方面发挥重要作用,但显然在大多数情况下恶性细胞会逃避免疫监视。鉴于抗癌疫苗的效果已达到瓶颈,目前尚无疫苗接种方案被指定为标准抗癌疗法,剖析肿瘤免疫逃逸背后的分子事件是使抗癌疫苗成为一种有效到足以在常规临床环境中实施的治疗武器的必要条件。近年来,我们对肿瘤免疫逃逸背后的分子机制的理解有了重大进展。这些机制性见解正在推动旨在逆转破坏有效抗肿瘤免疫反应的免疫抑制回路的合理设计疗法的发展。在这篇综述中,概述了使癌细胞逃避免疫监视的最具特征的机制,并突出了构成这一复杂领域的最具争议的争议点。此外,还描述了为克服肿瘤免疫逃逸而设计的最新治疗策略,特别关注那些进入临床阶段研究的策略。