Department of Hematology and Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
Division of Hematology and Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
J Hematol Oncol. 2021 Mar 19;14(1):45. doi: 10.1186/s13045-021-01056-8.
The immune system is the core defense against cancer development and progression. Failure of the immune system to recognize and eliminate malignant cells plays an important role in the pathogenesis of cancer. Tumor cells evade immune recognition, in part, due to the immunosuppressive features of the tumor microenvironment. Immunotherapy augments the host immune system to generate an antitumor effect. Immune checkpoints are pathways with inhibitory or stimulatory features that maintain self-tolerance and assist with immune response. The most well-described checkpoints are inhibitory in nature and include the cytotoxic T lymphocyte-associated molecule-4 (CTLA-4), programmed cell death receptor-1 (PD-1), and programmed cell death ligand-1 (PD-L1). Molecules that block these pathways to enhance the host immunologic activity against tumors have been developed and become standard of care in the treatment of many malignancies. Only a small percentage of patients have meaningful responses to these treatments, however. New pathways and molecules are being explored in an attempt to improve responses and application of immune checkpoint inhibition therapy. In this review, we aim to elucidate these novel immune inhibitory pathways, potential therapeutic molecules that are under development, and outline particular advantages and challenges with the use of each one of them.
免疫系统是抵御癌症发展和进展的核心防御机制。免疫系统未能识别和消除恶性细胞,在癌症的发病机制中起着重要作用。肿瘤细胞逃避免疫识别,部分原因是肿瘤微环境具有免疫抑制特征。免疫疗法增强了宿主免疫系统,产生抗肿瘤作用。免疫检查点是具有抑制或刺激特征的途径,可维持自身耐受并有助于免疫反应。最著名的检查点具有抑制性,包括细胞毒性 T 淋巴细胞相关分子 4(CTLA-4)、程序性细胞死亡受体 1(PD-1)和程序性细胞死亡配体 1(PD-L1)。已经开发出了阻断这些途径的分子,以增强宿主对肿瘤的免疫活性,并成为许多恶性肿瘤治疗的标准。然而,只有一小部分患者对这些治疗有明显的反应。目前正在探索新的途径和分子,以试图提高免疫检查点抑制治疗的反应和应用。在这篇综述中,我们旨在阐明这些新的免疫抑制途径、正在开发的潜在治疗分子,并概述每种分子的特定优势和挑战。