Yang Bin, Gao Jing, Pei Qing, Xu Huixiong, Yu Haijun
State Key Laboratory of Drug Research & Center of Pharmaceutics Shanghai Institute of Materia Medica Chinese Academy of Sciences Shanghai 201203 China.
Department of Medical Ultrasound Shanghai Tenth People's Hospital Ultrasound Research and Education Institute Tongji University School of Medicine Tongji University Cancer Center Shanghai 200072 China.
Adv Sci (Weinh). 2020 Oct 25;7(23):2002365. doi: 10.1002/advs.202002365. eCollection 2020 Dec.
Immunotherapy has shifted the clinical paradigm of cancer management. However, despite promising initial progress, immunotherapeutic approaches to cancer still suffer from relatively low response rates and the possibility of severe side effects, likely due to the low inherent immunogenicity of tumor cells, the immunosuppressive tumor microenvironment, and significant inter- and intratumoral heterogeneity. Recently, nanoformulations of prodrugs have been explored as a means to enhance cancer immunotherapy by simultaneously eliciting antitumor immune responses and reversing local immunosuppression. Prodrug nanomedicines, which integrate engineering advances in chemistry, oncoimmunology, and material science, are rationally designed through chemically modifying small molecule drugs, peptides, or antibodies to yield increased bioavailability and spatiotemporal control of drug release and activation at the target sites. Such strategies can help reduce adverse effects and enable codelivery of multiple immune modulators to yield synergistic cancer immunotherapy. In this review article, recent advances and translational challenges facing prodrug nanomedicines for cancer immunotherapy are overviewed. Last, key considerations are outlined for future efforts to advance prodrug nanomedicines aimed to improve antitumor immune responses and combat immune tolerogenic microenvironments.
免疫疗法已经改变了癌症治疗的临床模式。然而,尽管初期取得了令人鼓舞的进展,但癌症免疫治疗方法仍然存在相对较低的响应率以及出现严重副作用的可能性,这可能是由于肿瘤细胞固有的免疫原性较低、免疫抑制性肿瘤微环境以及肿瘤间和肿瘤内显著的异质性所致。最近,前药的纳米制剂已被探索作为一种通过同时引发抗肿瘤免疫反应和逆转局部免疫抑制来增强癌症免疫治疗的手段。前药纳米药物整合了化学、肿瘤免疫学和材料科学方面的工程进展,通过对小分子药物、肽或抗体进行化学修饰来合理设计,以提高生物利用度,并在靶位点实现药物释放和激活的时空控制。此类策略有助于减少不良反应,并能够共同递送多种免疫调节剂以产生协同的癌症免疫治疗效果。在这篇综述文章中,概述了前药纳米药物在癌症免疫治疗方面的最新进展和转化挑战。最后,概述了未来推进前药纳米药物以改善抗肿瘤免疫反应和对抗免疫耐受性微环境的关键考虑因素。