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前列腺癌特异性免疫疗法的进展。

Advances in specific immunotherapy for prostate cancer.

作者信息

Kiessling Andrea, Füssel Susanne, Wehner Rebekka, Bachmann Michael, Wirth Manfred P, Rieber E Peter, Schmitz Marc

机构信息

Institute of Immunology, Medical Faculty, Technical University of Dresden, Dresden, Germany.

出版信息

Eur Urol. 2008 Apr;53(4):694-708. doi: 10.1016/j.eururo.2007.11.043. Epub 2007 Nov 26.

Abstract

OBJECTIVES

The absence of effective therapies for advanced prostate cancer has entailed an intensive search for novel treatments. This review presents an overview of specific immunotherapeutic strategies for prostate cancer.

METHODS

Current literature was reviewed regarding the identification of tumor antigens and the design of T-cell- and antibody-based immunotherapy for prostate cancer. The PubMed database was searched using the key words antibodies, clinical trials, dendritic cells, immunotherapy, prostate cancer, and T cells.

RESULTS

T cells and antibodies are powerful components of the specific antitumor immune response. CD8+ cytotoxic T lymphocytes (CTLs) efficiently destroy tumor cells. CD4+ T cells improve the antigen-presenting capacity of dendritic cells (DCs) and support the stimulation of tumor-reactive CTLs. Monoclonal antibodies exhibit their antitumor effects via antibody-dependent cellular cytotoxicity and complement activation. Consequently, much attention has been given to the identification of tumor antigens that represent attractive targets for specific immunotherapy. Several prostate cancer-related antigens were described and used in clinical trials. Such studies were based on the administration of peptides, proteins, or DNA. Furthermore, men with prostate cancer were vaccinated with peptide-, protein-, or RNA-loaded DCs, which display an extraordinary capacity to induce tumor-reactive T cells. Monoclonal antibodies directed against surface antigens were also used. Clinical trials revealed that immunotherapeutic strategies represent safe and feasible concepts for the induction of immunologic and clinical responses in men with prostate cancer.

CONCLUSIONS

Specific immunotherapy represents a promising treatment modality for prostate cancer. Further improvement of the current approaches is required and may be achieved by combining T-cell- and antibody-based vaccination strategies with radio-, hormone-, chemo-, or antiangiogenic therapy.

摘要

目的

晚期前列腺癌缺乏有效的治疗方法,因此人们一直在积极寻找新的治疗方法。本综述概述了前列腺癌的特定免疫治疗策略。

方法

回顾了当前关于肿瘤抗原的鉴定以及基于T细胞和抗体的前列腺癌免疫治疗设计的文献。使用关键词抗体、临床试验、树突状细胞、免疫治疗、前列腺癌和T细胞搜索PubMed数据库。

结果

T细胞和抗体是特异性抗肿瘤免疫反应的强大组成部分。CD8+细胞毒性T淋巴细胞(CTL)能有效破坏肿瘤细胞。CD4+T细胞可提高树突状细胞(DC)的抗原呈递能力,并支持对肿瘤反应性CTL的刺激。单克隆抗体通过抗体依赖性细胞毒性和补体激活发挥其抗肿瘤作用。因此,人们非常关注鉴定作为特异性免疫治疗有吸引力靶点的肿瘤抗原。描述了几种与前列腺癌相关的抗原并用于临床试验。此类研究基于肽、蛋白质或DNA的给药。此外,用负载肽、蛋白质或RNA的DC对前列腺癌患者进行疫苗接种,这些DC具有诱导肿瘤反应性T细胞的非凡能力。也使用了针对表面抗原的单克隆抗体。临床试验表明,免疫治疗策略是诱导前列腺癌患者产生免疫和临床反应的安全可行的概念。

结论

特异性免疫治疗是前列腺癌一种有前景的治疗方式。需要对当前方法进行进一步改进,可通过将基于T细胞和抗体的疫苗接种策略与放疗、激素治疗、化疗或抗血管生成治疗相结合来实现。

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