Solid Tumors Program. Division of Oncology, Center for Applied Medical Research, University of Navarra (CIMA), Navarra, Spain.
Oncology, Clínica University of Navarra, Navarra, Spain.
Clin Cancer Res. 2023 Jun 13;29(12):2184-2193. doi: 10.1158/1078-0432.CCR-22-1681.
ENPP1 (ecto-nucleotide pyrophosphatase/phosphodiesterase) participates in the hydrolysis of different purine nucleotides in an array of physiologic processes. However, ENPP1 is frequently overexpressed in local relapses and tumor metastases, which are associated with poor prognosis and survival in a range of solid tumors. ENPP1 promotes an immunosuppressive tumor microenvironment (TME) by tilting the balance of ATP/adenosine (Ado) in conjunction with other components (CD38, CD39/ENTPD1, and CD73/NT5E). Moreover, ENPP1 intersects with the stimulator of interferon genes (STING), impairing its robust immune response through the hydrolysis of the effector 2´,3´-cyclic GMP-AMP. Thus, ENPP1 blockade emerges as a unique target eliciting immune remodeling and leveraging the STING pathway. Several ENPP1 inhibitors have shown an immunostimulatory effect, and their combination with other therapeutic modalities, such as immune-checkpoint blockade, STING activation, DNA damage response (DDR) inhibitors, and radiotherapy (RT), represents a promising avenue to boost antitumor-immune responses and to improve current clinical outcomes in several tumors. This comprehensive review summarizes the current state of the art and opens new perspectives for novel treatment strategies.
核苷酸焦磷酸酶/磷酸二酯酶 1(ENPP1)参与多种生理过程中不同嘌呤核苷酸的水解。然而,ENPP1 在局部复发和肿瘤转移中经常过表达,与多种实体瘤的不良预后和生存相关。ENPP1 通过与其他成分(CD38、CD39/ENTPD1 和 CD73/NT5E)一起使 ATP/腺苷(Ado)平衡倾斜,从而促进免疫抑制性肿瘤微环境(TME)。此外,ENPP1 与干扰素基因刺激物(STING)交叉,通过水解效应物 2´,3´-环鸟苷酸-AMP 来损害其强大的免疫反应。因此,ENPP1 阻断被认为是一种独特的靶点,可以引发免疫重塑并利用 STING 途径。几种 ENPP1 抑制剂已显示出免疫刺激作用,将其与其他治疗方式(如免疫检查点阻断、STING 激活、DNA 损伤反应(DDR)抑制剂和放疗(RT))联合使用,代表了提高抗肿瘤免疫反应和改善几种肿瘤当前临床结果的有前途的途径。这篇综述总结了目前的最新进展,并为新的治疗策略开辟了新的视角。