治疗胶质母细胞瘤的免疫治疗的耐药机制和障碍。

Resistance Mechanisms and Barriers to Successful Immunotherapy for Treating Glioblastoma.

机构信息

Host-Tumour Interactions Group, Division of Cancer and Stem Cells, BioDiscovery Institute, University of Nottingham, Nottingham, NG7 2RD, UK.

Antibody and Vaccine Group, Centre for Cancer Immunology, University of Southampton, Southampton General Hospital, Southampton, Hants, SO16 6YD, UK.

出版信息

Cells. 2020 Jan 21;9(2):263. doi: 10.3390/cells9020263.

Abstract

Glioblastoma (GBM) is inevitably refractory to surgery and chemoradiation. The hope for immunotherapy has yet to be realised in the treatment of GBM. Immune checkpoint blockade antibodies, particularly those targeting the Programme death 1 (PD-1)/PD-1 ligand (PD-L1) pathway, have improved the prognosis in a range of cancers. However, its use in combination with chemoradiation or as monotherapy has proved unsuccessful in treating GBM. This review focuses on our current knowledge of barriers to immunotherapy success in treating GBM, such as diminished pre-existing anti-tumour immunity represented by low levels of expression, low tumour mutational burden and a severely exhausted T-cell tumour infiltrate. Likewise, systemic T-cell immunosuppression is seen driven by tumoural factors and corticosteroid use. Furthermore, unique anatomical differences with primary intracranial tumours such as the blood-brain barrier, the type of antigen-presenting cells and lymphatic drainage contribute to differences in treatment success compared to extracranial tumours. There are, however, shared characteristics with those known in other tumours such as the immunosuppressive tumour microenvironment. We conclude with a summary of ongoing and future immune combination strategies in GBM, which are representative of the next wave in immuno-oncology therapeutics.

摘要

胶质母细胞瘤(GBM)不可避免地对手术和放化疗具有抗药性。免疫疗法在 GBM 的治疗中尚未得到实现。免疫检查点阻断抗体,特别是针对程序性死亡受体 1(PD-1)/PD-1 配体(PD-L1)途径的抗体,改善了多种癌症的预后。然而,在与放化疗联合使用或作为单一疗法治疗 GBM 时,其效果并不理想。这篇综述重点介绍了我们目前对免疫疗法在治疗 GBM 中成功的障碍的认识,例如代表低水平表达的预先存在的抗肿瘤免疫能力减弱、低肿瘤突变负担和严重耗尽的 T 细胞肿瘤浸润。同样,全身性 T 细胞免疫抑制是由肿瘤因素和皮质类固醇的使用驱动的。此外,与原发性颅内肿瘤的独特解剖差异,如血脑屏障、抗原呈递细胞类型和淋巴引流,导致与颅外肿瘤相比,治疗效果存在差异。然而,与其他肿瘤中已知的特征存在相似之处,如免疫抑制性肿瘤微环境。我们总结了目前正在进行的和未来的免疫联合策略在 GBM 中的应用,这些策略代表了免疫肿瘤治疗学的下一波浪潮。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2536/7072315/4bc2479e301c/cells-09-00263-g001.jpg

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