Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan.
Division of Cancer Immunology, Research Institute/EPOC, National Cancer Center, Tokyo/Chiba, Japan.
Ann N Y Acad Sci. 2018 Apr;1417(1):104-115. doi: 10.1111/nyas.13625. Epub 2018 Mar 22.
Cancer immunotherapy involving blockade of immune checkpoint molecules, such as CTLA-4 and PD-1, has shown remarkable clinical success across several types of malignancies. However, a fraction of patients experience disease progression after treatment; thus, exploring resistant mechanisms for immune checkpoint inhibitors and improving their treatment outcome with additional modalities are of great importance. CD4 regulatory T (T ) cells characterized by expression of the master regulatory transcription factor FOXP3 are a highly immune-suppressive subset of CD4 T cells that maintain immune homeostasis. Several preclinical and clinical studies suggest that T cells hamper immune surveillance against cancer in healthy individuals, prevent the development of effective antitumor immunity in tumor-bearing patients, and promote tumor progression. Therefore, targeting T cells should be crucial to improving the treatment outcomes of cancer immunotherapy. Several clinical studies directly or indirectly targeting T cells in combination with immune checkpoint inhibitors are ongoing or being planned. Understanding the characteristics and roles of T cells in cancer settings could make disease-specific T -targeted therapy more efficacious and reduce the incidence of immune-related adverse effects mediated by T cell inhibition.
癌症免疫疗法涉及阻断免疫检查点分子,如 CTLA-4 和 PD-1,已在多种恶性肿瘤中显示出显著的临床疗效。然而,一部分患者在治疗后会出现疾病进展;因此,探索免疫检查点抑制剂的耐药机制,并通过其他方式改善其治疗效果非常重要。CD4 调节性 T(Treg)细胞的特征是表达主调控转录因子 FOXP3,是 CD4 T 细胞中具有高度免疫抑制功能的亚群,可维持免疫稳态。一些临床前和临床研究表明,T 细胞在健康个体中阻碍了对癌症的免疫监视,阻止了肿瘤患者中有效抗肿瘤免疫的发展,并促进了肿瘤的进展。因此,靶向 T 细胞对于改善癌症免疫疗法的治疗效果至关重要。目前正在进行或计划进行几项直接或间接靶向 T 细胞与免疫检查点抑制剂联合治疗的临床研究。了解 T 细胞在癌症环境中的特征和作用,可以使针对特定疾病的 T 细胞靶向治疗更有效,并降低 T 细胞抑制介导的免疫相关不良事件的发生率。