Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK, USA.
Int J Hyperthermia. 2020 Dec;37(3):4-17. doi: 10.1080/02656736.2020.1810333.
FDA approval of anti-CTLA4 in 2011 for melanoma immunotherapy was paradigm shifting and dramatically accelerated cancer immunotherapy research. The investment and effort have been exceptionally large, with a commensurate impressive pace of discovery. Historical and current research has validated the following key points: tumors are recognized by the immune system; tumors develop an immunosuppressive environment which suppresses the antitumor immune response; successful immunotherapy must overcome that tumor-mediated immunosuppression. While cancer immunotherapy research expanded, a parallel effort developing nanoparticles (NP) for cancer diagnosis and therapy also received major investment and expanded. Initially the two efforts appeared to have minimal synergy. Systemically administered nanoparticles are rapidly ingested by phagocytic leukocytes, and therefore nanotechnologists developed strategies to avoid NP ingestion by leukocytes in order to accomplish nanoparticle accumulation in tumors rather than liver and spleen. Recently, nanotechnology and cancer immunotherapy have increasingly merged since phagocytic leukocytes are the key to reversing the local tumor immunosuppression and the tendency of NP to be phagocytosed can be exploited to manipulate phagocytes for immunotherapy. This review focuses on vaccination (ISV), an immunotherapy approach that can utilize direct injection of immunostimulatory reagents, including NPs, into tumors to disrupt the local immunosuppression, stimulate effective immune response against the treated tumor, and most importantly, generate a systemic antitumor immune response to eliminate metastatic tumors. While there are many specific options for using NP for ISV (reviewed further in this special issue), this review focuses on immunology concepts needed to understand and design successful NP ISV approaches.
FDA 于 2011 年批准 CTLA4 抗体用于黑色素瘤免疫治疗,这一举措具有划时代的意义,极大地推动了癌症免疫治疗的研究。大量的投资和努力带来了令人瞩目的发现速度。历史和当前的研究证实了以下关键要点:免疫系统能够识别肿瘤;肿瘤会发展出一种免疫抑制环境,从而抑制抗肿瘤免疫反应;成功的免疫疗法必须克服肿瘤介导的免疫抑制。随着癌症免疫治疗研究的扩展,用于癌症诊断和治疗的纳米颗粒(NP)的平行研究也得到了大量投资和扩展。最初,这两项研究似乎没有什么协同作用。系统性给予的纳米颗粒会被吞噬性白细胞迅速摄取,因此纳米技术研究人员开发了避免 NP 被白细胞摄取的策略,以实现 NP 在肿瘤中的积累,而不是在肝脏和脾脏中积累。最近,由于吞噬性白细胞是逆转局部肿瘤免疫抑制和 NP 被吞噬倾向的关键,因此纳米技术和癌症免疫治疗越来越融合,NP 被吞噬的倾向可以被利用来操纵吞噬细胞进行免疫治疗。本文重点介绍免疫刺激疫苗(ISV),这是一种免疫治疗方法,可以直接将免疫刺激试剂(包括 NP)注入肿瘤中,以破坏局部免疫抑制,刺激针对治疗肿瘤的有效免疫反应,最重要的是,产生全身性抗肿瘤免疫反应以消除转移性肿瘤。虽然有许多使用 NP 进行 ISV 的具体选择(在本特刊中进一步讨论),但本文重点介绍了理解和设计成功的 NP ISV 方法所需的免疫学概念。