Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA.
Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Wiley Interdiscip Rev Nanomed Nanobiotechnol. 2021 Jul;13(4):e1698. doi: 10.1002/wnan.1698. Epub 2021 Jan 18.
Cancer metastasis, the spread of disease from a primary to a distal site through the circulatory or lymphatic systems, accounts for over 90% of all cancer related deaths. Despite significant progress in the field of cancer therapy in recent years, mortality rates remain dramatically higher for patients with metastatic disease versus those with local or regional disease. Although there is clearly an urgent need to develop drugs that inhibit cancer spread, the overwhelming majority of anticancer therapies that have been developed to date are designed to inhibit tumor growth but fail to address the key stages of the metastatic process: invasion, intravasation, circulation, extravasation, and colonization. There is growing interest in engineering targeted therapeutics, such as antibody drugs, that inhibit various steps in the metastatic cascade. We present an overview of antibody therapeutic approaches, both in the pipeline and in the clinic, that disrupt the essential mechanisms that underlie cancer metastasis. These therapies include classes of antibodies that indirectly target metastasis, including anti-integrin, anticadherin, and immune checkpoint blocking antibodies, as well as monoclonal and bispecific antibodies that are specifically designed to interrupt disease dissemination. Although few antimetastatic antibodies have achieved clinical success to date, there are many promising candidates in various stages of development, and novel targets and approaches are constantly emerging. Collectively, these efforts will enrich our understanding of the molecular drivers of metastasis, and the new strategies that arise promise to have a profound impact on the future of cancer therapeutic development. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease.
癌症转移,即疾病通过循环或淋巴系统从原发部位扩散到远处部位,占所有癌症相关死亡的 90%以上。尽管近年来癌症治疗领域取得了重大进展,但转移性疾病患者的死亡率仍明显高于局部或区域性疾病患者。尽管显然迫切需要开发抑制癌症扩散的药物,但迄今为止开发的绝大多数抗癌疗法旨在抑制肿瘤生长,但未能解决转移过程的关键阶段:侵袭、血管内渗、循环、血管外渗和定植。人们越来越关注工程靶向治疗药物,如抗体药物,这些药物可以抑制转移级联反应中的各种步骤。我们概述了正在研发中和临床上的抗体治疗方法,这些方法破坏了癌症转移的基本机制。这些疗法包括间接靶向转移的抗体类别,包括抗整合素、抗钙粘蛋白和免疫检查点阻断抗体,以及专门设计用于中断疾病传播的单克隆和双特异性抗体。尽管迄今为止,少数抗转移抗体已取得临床成功,但仍有许多有前途的候选药物处于不同的开发阶段,新的靶点和方法也在不断涌现。总的来说,这些努力将丰富我们对转移的分子驱动因素的理解,出现的新策略有望对癌症治疗开发的未来产生深远影响。本文属于治疗方法和药物发现>肿瘤疾病的纳米医学类别。