Department of Pathophysiology, College of Medicine, Southeast University, Nanjing 210000, Jiangsu Province, China.
Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210000, Jiangsu Province, China.
World J Gastroenterol. 2022 Oct 7;28(37):5403-5419. doi: 10.3748/wjg.v28.i37.5403.
Gastrointestinal cancer (GIC) is the most common cancer with a poor prognosis. Currently, surgery is the main treatment for GIC. However, the high rate of postoperative recurrence leads to a low five-year survival rate. In recent years, immunotherapy has received much attention. As the only immunotherapy drugs approved by the Food and Drug Administration (FDA), immune checkpoint blockade (ICB) drugs have great potential in cancer therapy. Nevertheless, the efficacy of ICB treatment is greatly limited by the low immunogenicity and immunosuppressive microenvironment of GIC. Therefore, the targets of immunotherapy have expanded from ICB to increasing tumor immunogenicity, increasing the recruitment and maturation of immune cells and reducing the proportion of inhibitory immune cells, such as M2-like macrophages, regulatory T cells and myeloid-derived suppressor cells. Moreover, with the development of nanotechnology, a variety of nanoparticles have been approved by the FDA for clinical therapy, so novel nanodrug delivery systems have become a research focus for anticancer therapy. In this review, we summarize recent advances in the application of immunotherapy-based nanoparticles in GICs, such as gastric cancer, hepatocellular carcinoma, colorectal cancer and pancreatic cancer, and described the existing challenges and future trends.
胃肠道癌症(GIC)是预后最差的最常见癌症。目前,手术是 GIC 的主要治疗方法。然而,术后复发率高导致五年生存率低。近年来,免疫疗法受到了广泛关注。作为食品和药物管理局(FDA)唯一批准的免疫疗法药物,免疫检查点阻断(ICB)药物在癌症治疗方面具有巨大潜力。然而,ICB 治疗的疗效受到 GIC 低免疫原性和免疫抑制微环境的极大限制。因此,免疫疗法的靶点已经从 ICB 扩展到提高肿瘤免疫原性、增加免疫细胞的募集和成熟以及减少抑制性免疫细胞(如 M2 样巨噬细胞、调节性 T 细胞和髓系来源的抑制细胞)的比例。此外,随着纳米技术的发展,FDA 已经批准了多种用于临床治疗的纳米粒子,因此新型纳米药物递送系统已成为抗癌治疗的研究重点。本综述总结了免疫疗法纳米粒子在胃癌、肝癌、结直肠癌和胰腺癌等 GIC 中的应用的最新进展,并描述了当前的挑战和未来的趋势。
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