从肿瘤免疫监视和免疫编辑角度理解 OMIC 特征:黑色素瘤与免疫细胞在免疫治疗中的相互作用。

OMIC signatures to understand cancer immunosurveillance and immunoediting: Melanoma and immune cells interplay in immunotherapy.

机构信息

Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, México.

Universidad Nacional Autónoma de México (UNAM), México Ciudad de México, México.

出版信息

J Leukoc Biol. 2019 May;105(5):915-933. doi: 10.1002/JLB.MR0618-241RR. Epub 2019 Jan 30.

Abstract

Melanoma is the deadliest form of skin cancer. Cutaneous melanomas usually originate from exposure to the mutagenic effects of ultraviolet radiation, and as such they exhibit the highest rate of somatic mutations than any other human cancer, and an extensive expression of neoantigens concurrently with a dense infiltrate of immune cells. The coexistence of high immunogenicity and high immune cell infiltration may sound contradictory for cancers carrying a gloomy outcome. However, recent studies have unveiled a variety of immunosuppressive mechanisms that often permeate the tumor microenvironment and that are responsible for tumor escaping from immunosurveillance mechanisms. Nonetheless, this particular immune profile has opened a new window of treatments based on immunotherapy that have significantly improved the clinical outcome of melanoma patients. Still, positive and complete therapy responses have been limited, and this particular cancer continues to be a major clinical challenge. The transcriptomic signatures of those patients with clinical benefit and those with progressive disease have provided a more complete picture of the universe of interactions between the tumor and the immune system. In this review, we integrate the results of the immunotherapy clinical trials to discuss a novel understanding of the mechanisms guiding cancer immunosurveillance and immunoediting. A clear notion of the cellular and molecular processes shaping how the immune system and the tumor are continuously coevolving would result in the rational design of combinatory therapies aiming to counteract the signaling pathways and cellular processes responsible for immunoescape mechanisms and provide clinical benefit to immunotherapy nonresponsive patients.

摘要

黑色素瘤是皮肤癌中最致命的一种。皮肤黑色素瘤通常起源于暴露于致突变紫外线辐射的影响,因此它们表现出比任何其他人类癌症更高的体细胞突变率,并且同时伴随着大量新抗原的表达和免疫细胞的密集浸润。高免疫原性和高免疫细胞浸润的共存对于预后不佳的癌症来说似乎有些矛盾。然而,最近的研究揭示了多种免疫抑制机制,这些机制常常渗透到肿瘤微环境中,导致肿瘤逃避免疫监视机制。尽管如此,这种特殊的免疫特征为免疫疗法治疗开辟了新的途径,显著改善了黑色素瘤患者的临床预后。尽管如此,阳性和完全的治疗反应仍然有限,这种特殊的癌症仍然是一个主要的临床挑战。具有临床获益和进展性疾病的患者的转录组特征提供了一个更完整的肿瘤和免疫系统之间相互作用的全景。在这篇综述中,我们整合了免疫治疗临床试验的结果,讨论了指导癌症免疫监视和免疫编辑的机制的新认识。对塑造免疫系统和肿瘤不断共同进化的细胞和分子过程的清晰认识,将导致合理设计联合治疗的策略,以对抗负责免疫逃逸机制的信号通路和细胞过程,并为免疫治疗无反应的患者提供临床获益。

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