Steele Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
Clin Cancer Res. 2011 Apr 15;17(8):2074-80. doi: 10.1158/1078-0432.CCR-10-2636. Epub 2011 Feb 24.
Addition of multiple molecularly targeted agents to the existing armamentarium of chemotherapeutics and radiotherapies represents a significant advance in the management of several advanced cancers. In certain tumor types with no efficacious therapy options, these agents have become the first line of therapy, for example, sorafenib in advanced hepatocellular carcinoma or bevacizumab in recurrent glioblastoma. Unfortunately, in many cases, the survival benefits are modest, lasting only weeks to a few months. Moreover, they may not show benefit in patients with localized disease (i.e., in the adjuvant setting). Recent studies have provided increasing evidence that activation of the chemokine CXCL12 (SDF1α) pathway is a potential mechanism of tumor resistance to both conventional therapies and biological agents via multiple complementary actions: (i) by directly promoting cancer cell survival, invasion, and the cancer stem and/or tumor-initiating cell phenotype; (ii) by recruiting "distal stroma" (i.e., myeloid bone marrow-derived cells) to indirectly facilitate tumor recurrence and metastasis; and (iii) by promoting angiogenesis directly or in a paracrine manner. Here, we discuss recent preclinical and clinical data that support the potential use of anti-CXCL12 agents (e.g., AMD3100, NOX-A12, or CCX2066) as sensitizers to currently available therapies by targeting the CXCL12/CXCR4 and CXCL12/CXCR7 pathways.
添加多种针对分子靶点的药物,为化学疗法和放射疗法的现有武器库增添了新的治疗手段,这代表着几种晚期癌症治疗的重大进展。在某些肿瘤类型中,尚无有效的治疗方法,这些药物已成为一线治疗药物,例如索拉非尼治疗晚期肝细胞癌,或贝伐珠单抗治疗复发性胶质母细胞瘤。不幸的是,在许多情况下,这些药物带来的生存获益有限,仅持续数周至数月。此外,它们在局部疾病患者(即辅助治疗环境)中可能没有获益。最近的研究提供了越来越多的证据,表明趋化因子 CXCL12(基质细胞衍生因子 1α,SDF1α)途径的激活是肿瘤对常规治疗和生物制剂产生耐药性的一个潜在机制,通过多种互补作用实现:(i)直接促进癌细胞存活、侵袭和癌症干细胞和/或肿瘤起始细胞表型;(ii)通过招募“远端基质”(即骨髓源性细胞)间接促进肿瘤复发和转移;(iii)通过直接或旁分泌方式促进血管生成。在这里,我们讨论了最近的临床前和临床数据,这些数据支持使用抗 CXCL12 药物(例如 AMD3100、NOX-A12 或 CCX2066)作为增敏剂,通过靶向 CXCL12/CXCR4 和 CXCL12/CXCR7 途径,增强现有治疗方法的效果。