Korea University Anam Hospital, Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
Korea University Anam Hospital, Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
J Control Release. 2021 Mar 10;331:321-334. doi: 10.1016/j.jconrel.2021.01.009. Epub 2021 Jan 9.
Cancer immunotherapy (CI) represented by immune checkpoint inhibitors (ICIs) presents a new paradigm for cancer treatment. However, the types of cancer that attain a therapeutic benefit from ICIs are limited, and the efficacy of these treatments does not meet expectations. To date, research on ICIs has mainly focused on identifying biomarkers and patient characteristics that can enhance the therapeutic effect on tumors. However, studies on combinational strategies for CI are being actively conducted to overcome the resistance to ICI treatment. Moreover, it has been confirmed that dramatic anticancer effects are achieved through "neoadjuvant" immunotherapy with ICIs in treatment-naïve cancer patients; consequently, it has become necessary to consider how to best apply cancer immunotherapies for patients, even with respect to their tumor stages. In this review, we sought to discuss the right timing of ICI treatment in consideration of the progression of cancer with a changing tumor-immune microenvironment. Furthermore, we investigated which types of combinational treatments and their corresponding sequences of administration could optimize the therapeutic effect of ICIs to expand the applicable target of ICIs and increase their therapeutic efficacy. Finally, we discussed several delivery pathways and methods that can maximize the effect of ICIs.
癌症免疫疗法（CI）以免疫检查点抑制剂（ICI）为代表，为癌症治疗带来了新的范例。然而，能从 ICI 中获得治疗益处的癌症类型有限，这些治疗的疗效也不尽如人意。迄今为止，ICI 的研究主要集中在确定能够增强对肿瘤治疗效果的生物标志物和患者特征上。然而，正在积极开展针对 CI 的联合策略研究，以克服对 ICI 治疗的耐药性。此外，已经证实，在未经治疗的癌症患者中进行“新辅助”ICI 免疫治疗可以实现显著的抗癌效果；因此，有必要考虑如何为患者最佳应用癌症免疫疗法，即使考虑到他们的肿瘤分期。在这篇综述中，我们试图讨论在考虑肿瘤免疫微环境不断变化的情况下，ICI 治疗的最佳时机。此外，我们研究了哪种类型的联合治疗及其相应的给药顺序可以优化 ICI 的治疗效果，以扩大 ICI 的适用靶点并提高其治疗效果。最后，我们讨论了几种可以最大限度发挥 ICI 效果的给药途径和方法。
