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癌症免疫疗法的当前模式:免疫调节抗体、嵌合抗原受体和疫苗。

Current modalities in cancer immunotherapy: Immunomodulatory antibodies, CARs and vaccines.

机构信息

University of Pittsburgh School of Medicine, Department of Immunology, Pittsburgh, PA, USA.

University of Pittsburgh School of Medicine, Department of Immunology, Pittsburgh, PA, USA.

出版信息

Pharmacol Ther. 2017 Oct;178:31-47. doi: 10.1016/j.pharmthera.2017.03.008. Epub 2017 Mar 16.

Abstract

Successes of immune checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR) T cell therapy in curing patients with otherwise lethal cancers have validated immunotherapy as a treatment for cancer and have inspired excitement for its broader potential. Most promising is the ability of each approach to eliminate bulky and advanced-stage cancers and to achieve durable cures. Despite this success, to date only a subset of cancer patients and a limited number of cancer types respond to these therapies. A major goal now is to expand the types of cancer and number of patients who can be successfully treated. To this end a multitude of immunotherapies are being tested clinically in new combinations, and many new immunomodulatory antibodies and CARs are in development. A third major immunotherapeutic approach with renewed interest is cancer vaccines. While over 20years of therapeutic cancer vaccine trials have met with limited success, these studies have laid the groundwork for the use of therapeutic vaccines in combination with other immunotherapies or alone as prophylactic cancer vaccines. Prophylactic vaccines are now poised to revolutionize cancer prevention as they have done for the prevention of infectious diseases. In this review we examine three major cancer immunotherapy modalities: immunomodulatory antibodies, CAR T cell therapy and vaccines. For each we describe the current state of the art and outline major challenges and research directions forward.

摘要

免疫检查点抑制剂 (ICIs) 和嵌合抗原受体 (CAR) T 细胞疗法在治愈 otherwise lethal 癌症患者方面的成功,验证了免疫疗法是癌症治疗的一种方法,并激发了人们对其更广泛潜力的兴奋。最有前途的是这两种方法都有能力消除大体积和晚期癌症,并实现持久的治愈。尽管取得了这一成功,但迄今为止,只有一部分癌症患者和有限数量的癌症类型对这些治疗方法有反应。现在的一个主要目标是扩大可以成功治疗的癌症类型和患者数量。为此,正在临床中测试多种免疫疗法的新组合,并且正在开发许多新的免疫调节剂抗体和 CAR。第三种重新受到关注的主要免疫治疗方法是癌症疫苗。虽然 20 多年来的治疗性癌症疫苗试验取得的成功有限,但这些研究为在其他免疫疗法或预防性癌症疫苗中联合使用治疗性疫苗奠定了基础。预防性疫苗现在有望像预防传染病一样彻底改变癌症预防。在这篇综述中,我们研究了三种主要的癌症免疫治疗方式:免疫调节剂抗体、CAR T 细胞疗法和疫苗。对于每一种,我们描述了当前的技术状态,并概述了主要的挑战和研究方向。

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