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光热疗法增强癌症免疫检查点阻断治疗。

Photothermal therapies to improve immune checkpoint blockade for cancer.

机构信息

The George Washington Cancer Center, The George Washington University, Washington, DC, USA.

Thomas Jefferson High School for Science and Technology, Alexandria, VA, USA.

出版信息

Int J Hyperthermia. 2020 Dec;37(3):34-49. doi: 10.1080/02656736.2020.1797190.

Abstract

Immune checkpoint blockade (ICB) comprising monoclonal antibodies (mAbs) against immune 'checkpoints', such as CTLA-4 and the PD1/PDL1 axis have dramatically improved clinical outcomes for patients with cancer. However, ICB by itself has failed to provide benefit in a wide range of solid tumors, where recurrence still occurs with high incidence. These poor response rates may be due to the therapeutic shortcomings of ICB; namely, a lack of cancer-specific cytotoxicity and ability to debulk tumors. To overcome these limitations, effective ICB therapy may require the combination with other complementary therapeutic platforms. Here, we propose that photothermal therapy (PTT) is an ideal therapeutic modality for combination with ICB because it can generate both tumor-specific cytotoxicity and immunogenicity. PTT elicits these specific effects because it is a localized thermal ablation technique that utilizes light-responsive nanoparticles activated by a wavelength-matched laser. While ICB immunotherapy alone improves cancer immunogenicity but does not generate robust antitumor cytotoxicity, nanoparticle-based PTT elicits targeted and controlled cytotoxicity but sub-optimal long-term immunogenicity. Thus, the two platforms offer complementary and potentially synergistic antitumor effects, which will be detailed in this review. We highlight three classes of nanoparticles used as agents of PTT (i.e., metallic inorganic nanoparticles, carbon-based nanoparticles and organic dyes), and illustrate the potential for nanoparticle-based PTT to potentiate the effects of ICB in preclinical models. Through this discussion, we aim to present PTT combined with ICB as a potent synergistic combination treatment for diverse cancer types currently refractory to ICB as well as PTT monotherapies.

摘要

免疫检查点阻断(ICB)包括针对免疫“检查点”的单克隆抗体(mAbs),例如 CTLA-4 和 PD1/PDL1 轴,这显著改善了癌症患者的临床结果。然而,ICB 本身未能为广泛的实体瘤带来益处,这些肿瘤仍以高发生率复发。这些低反应率可能是由于 ICB 的治疗缺陷所致;即缺乏癌症特异性细胞毒性和肿瘤减容能力。为了克服这些局限性,有效的 ICB 治疗可能需要与其他互补的治疗平台相结合。在这里,我们提出光热疗法(PTT)是与 ICB 结合的理想治疗方式,因为它可以产生肿瘤特异性细胞毒性和免疫原性。PTT 产生这些特定的效果是因为它是一种利用光响应纳米颗粒的局部热消融技术,这些纳米颗粒由与激光匹配的波长激活。虽然单独的 ICB 免疫疗法可以提高癌症的免疫原性,但不能产生强大的抗肿瘤细胞毒性,基于纳米颗粒的 PTT 则会引发靶向和受控的细胞毒性,但长期免疫原性较差。因此,这两个平台提供互补且潜在协同的抗肿瘤作用,这将在本综述中详细阐述。我们强调了用作 PTT 剂的三类纳米颗粒(即金属无机纳米颗粒、碳基纳米颗粒和有机染料),并说明了基于纳米颗粒的 PTT 在临床前模型中增强 ICB 作用的潜力。通过这一讨论,我们旨在提出将 PTT 与 ICB 相结合,作为一种强大的协同联合治疗方法,用于目前对 ICB 以及 PTT 单药治疗有抗性的多种癌症类型。

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