Tannoury Mariana, Garnier Delphine, Susin Santos A, Bauvois Brigitte
Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, F-75006 Paris, France.
Cancers (Basel). 2022 Dec 7;14(24):6026. doi: 10.3390/cancers14246026.
Resistance to death is one of the hallmarks of human B cell malignancies and often contributes to the lack of a lasting response to today's commonly used treatments. Drug discovery approaches designed to activate the death machinery have generated a large number of inhibitors of anti-apoptotic proteins from the B-cell lymphoma/leukemia 2 family and the B-cell receptor (BCR) signaling pathway. Orally administered small-molecule inhibitors of Bcl-2 protein and BCR partners (e.g., Bruton's tyrosine kinase and phosphatidylinositol-3 kinase) have already been included (as monotherapies or combination therapies) in the standard of care for selected B cell malignancies. Agonistic monoclonal antibodies and their derivatives (antibody-drug conjugates, antibody-radioisotope conjugates, bispecific T cell engagers, and chimeric antigen receptor-modified T cells) targeting tumor-associated antigens (TAAs, such as CD19, CD20, CD22, and CD38) are indicated for treatment (as monotherapies or combination therapies) of patients with B cell tumors. However, given that some patients are either refractory to current therapies or relapse after treatment, novel therapeutic strategies are needed. Here, we review current strategies for managing B cell malignancies, with a focus on the ongoing clinical development of more effective, selective drugs targeting these molecules, as well as other TAAs and signaling proteins. The observed impact of metabolic reprogramming on B cell pathophysiology highlights the promise of targeting metabolic checkpoints in the treatment of these disorders.
对死亡的抵抗是人类B细胞恶性肿瘤的特征之一,常常导致对当今常用治疗方法缺乏持久反应。旨在激活死亡机制的药物发现方法已经产生了大量来自B细胞淋巴瘤/白血病2家族和B细胞受体(BCR)信号通路的抗凋亡蛋白抑制剂。口服的Bcl-2蛋白和BCR相关蛋白(如布鲁顿酪氨酸激酶和磷脂酰肌醇-3激酶)的小分子抑制剂已经被纳入(作为单一疗法或联合疗法)某些B细胞恶性肿瘤的治疗标准中。靶向肿瘤相关抗原(TAAs,如CD19、CD20、CD22和CD38)的激动性单克隆抗体及其衍生物(抗体-药物偶联物、抗体-放射性同位素偶联物、双特异性T细胞衔接器和嵌合抗原受体修饰的T细胞)被用于治疗(作为单一疗法或联合疗法)B细胞肿瘤患者。然而,鉴于一些患者对当前治疗方法耐药或治疗后复发,需要新的治疗策略。在这里,我们综述了当前治疗B细胞恶性肿瘤的策略,重点关注针对这些分子以及其他TAAs和信号蛋白的更有效、更具选择性的药物的临床开发进展。代谢重编程对B细胞病理生理学的影响凸显了靶向代谢检查点治疗这些疾病的前景。
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