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白血病的纳米医学、免疫疗法和联合疗法的研究进展。

Research advances in nanomedicine, immunotherapy, and combination therapy for leukemia.

机构信息

Institute of Regulatory Science for Medical Device, National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China.

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

出版信息

J Leukoc Biol. 2021 Feb;109(2):425-436. doi: 10.1002/JLB.5MR0620-063RR. Epub 2020 Aug 17.

Abstract

In the past decade, clinical and laboratory studies have led to important new insights into the biology of leukemia and its treatment. This review describes the progress of leukemia research in the United States in recent years. Whereas the traditional method of treatment is chemotherapy, it is nonselective and could induce systemic toxicities. Thus, in parallel with research on new chemotherapies, great emphasis has been placed on developing immunotherapies. Here, we will review the current immunotherapies available in research and development that overcome current challenges, specifically looking in the field of chimeric antigen receptor T-cell (CAR-T) therapies, checkpoint inhibitors, and antibody-drug conjugates. With about 100 clinical trials for CAR-T therapies and 30 in checkpoint inhibitors for leukemia treatment, scientists are trying to make these technologies cheaper, faster, and more feasible. Further describing the delivery of these therapeutics, we look at the current progress, clinical, and preclinical status of nano-based medicines such as liposomes, polymeric micelles, and metal nanoparticles. Taking advantage of their physicochemical and biologic properties, nanoparticles have been shown to increase the efficacy of commonly administered chemotherapies with reduced adverse effects.

摘要

在过去的十年中,临床和实验室研究为白血病的生物学及其治疗带来了重要的新见解。本综述描述了近年来美国在白血病研究方面的进展。虽然传统的治疗方法是化疗,但它是非选择性的,可能会引起全身毒性。因此,在研究新的化疗药物的同时,人们非常重视开发免疫疗法。在这里,我们将回顾当前正在研究和开发中的可克服当前挑战的免疫疗法,特别是在嵌合抗原受体 T 细胞(CAR-T)疗法、检查点抑制剂和抗体药物偶联物领域。对于 CAR-T 疗法,有大约 100 项临床试验,对于白血病治疗的检查点抑制剂,有 30 项临床试验,科学家们正在努力使这些技术更便宜、更快、更可行。进一步描述这些疗法的传递,我们研究了脂质体、聚合物胶束和金属纳米粒子等基于纳米的药物的当前进展、临床前和临床状态。利用其物理化学和生物学特性,纳米粒子已被证明可以提高常用化疗药物的疗效,同时减少不良反应。

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