Zhu Gui-Dong, Fu Yang-Xin
Department of Pathology, The University of Chicago, IL 60637, USA.
Yao Xue Xue Bao. 2013 Jul;48(7):1053-70.
Chemotherapy remains one of the major tools, along with surgery, radiotherapy, and more recently targeted therapy, in the war against cancer. There have appeared a plethora of highly potent cytotoxic drugs but the poor discriminability between cancerous and healthy cells of these agents limits their broader application in clinical settings. Therapeutic antibodies have emerged as an important class of biological anticancer agents, thanks to their ability in specific binding to tumor-associated antigens. While this important class of biologics can be used as single agents for the treatment of cancer through antibody-dependent cell cytotoxicity (ADCC), their therapeutical efficacy is often limited. Antitumor antibody drug conjugates (ADCs) combine the target-specificity of monoclonal antibody (mAb) and the highly active cell-killing drugs, taking advantages of the best characteristics out of both components. Thus, insufficiency of most naked mAbs in cancer therapy has been circumvented by arming the immunoglobulin with cytotoxic drugs. Here mAbs are used as vehicles to transport potent payloads to tumor cells. ADCs contain three main components: antibody, linker and cytotoxics (also frequently referred as payload). Antibodies can recognize and specifically bind to the tumor-specific antigens, leading to an antibody-assisted internalization, and payload release. While ADC has demonstrated tremendous success, a number of practical challenges limit the broader applications of this new class of anticancer therapy, including inefficient cellular uptake, low cytotoxicity, and off-target effects. This review article aims to cover recent advances in optimizing linkers with increased stability in circulation while allowing efficient payload release within tumor cells. We also attempt to provide some practical strategies in resolving the current challenges in this attractive research area, particularly to those new to the field.
化疗仍然是抗癌战争中的主要手段之一,与手术、放疗以及最近出现的靶向治疗并列。已经出现了大量高效的细胞毒性药物,但这些药物在癌细胞和健康细胞之间的辨别能力较差,限制了它们在临床环境中的更广泛应用。治疗性抗体已成为一类重要的生物抗癌药物,这得益于它们能够特异性结合肿瘤相关抗原。虽然这类重要的生物制剂可以通过抗体依赖性细胞毒性(ADCC)作为单一药物用于癌症治疗,但其治疗效果往往有限。抗肿瘤抗体药物偶联物(ADC)结合了单克隆抗体(mAb)的靶向特异性和高活性细胞杀伤药物,兼具了两种成分的最佳特性。因此,通过用细胞毒性药物武装免疫球蛋白,克服了大多数裸mAb在癌症治疗中的不足。在这里,mAb用作载体将强效药物输送到肿瘤细胞。ADC包含三个主要成分:抗体、连接子和细胞毒素(也常称为药物)。抗体可以识别并特异性结合肿瘤特异性抗原,导致抗体辅助内化和药物释放。虽然ADC已取得巨大成功,但一些实际挑战限制了这类新型抗癌疗法的更广泛应用,包括细胞摄取效率低、细胞毒性低和脱靶效应。这篇综述文章旨在涵盖在优化连接子方面的最新进展,使其在循环中具有更高的稳定性,同时允许在肿瘤细胞内有效释放药物。我们还试图提供一些实际策略来解决这一有吸引力的研究领域当前面临的挑战,特别是针对该领域的新手。