用于肝细胞癌治疗的免疫检查点和表观遗传调节剂的联合靶向治疗
Combinatorial targeting of immune checkpoints and epigenetic regulators for hepatocellular carcinoma therapy.
作者信息
Akce Mehmet, El-Rayes Bassel F, Wajapeyee Narendra
机构信息
Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center of University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, 35233, USA.
Department of Biochemistry and Molecular Genetics, O'Neal Comprehensive Cancer Center of University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, 35233, USA.
出版信息
Oncogene. 2023 Mar;42(14):1051-1057. doi: 10.1038/s41388-023-02646-1. Epub 2023 Mar 1.
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related mortality worldwide. The five-year survival rate of patients with unresectable HCC is about 12%. The liver tumor microenvironment (TME) is immune tolerant and heavily infiltrated with immunosuppressive cells. Immune checkpoint inhibitors (ICIs), in some cases, can reverse tumor cell immune evasion and enhance antitumor immunity. Rapidly evolving ICIs have expanded systemic treatment options in advanced HCC; however, single-agent ICIs achieve a limited 15-20% objective response rate in advanced HCC. Therefore, other combinatorial approaches that amplify the efficacy of ICIs or suppress other tumor-promoting pathways may enhance clinical outcomes. Epigenetic alterations (e.g., changes in chromatin states and non-genetic DNA modifications) have been shown to drive HCC tumor growth and progression as well as their response to ICIs. Recent studies have combined ICIs and epigenetic inhibitors in preclinical and clinical settings to contain several cancers, including HCC. In this review, we outline current ICI treatments for HCC, the mechanism behind their successes and failures, and how ICIs can be combined with distinct epigenetic inhibitors to increase the durability of ICIs and potentially treat "immune-cold" HCC.
肝细胞癌(HCC)是全球癌症相关死亡的第二大主要原因。不可切除的HCC患者的五年生存率约为12%。肝脏肿瘤微环境(TME)具有免疫耐受性,且大量浸润免疫抑制细胞。在某些情况下,免疫检查点抑制剂(ICIs)可以逆转肿瘤细胞的免疫逃逸并增强抗肿瘤免疫力。快速发展的ICIs扩大了晚期HCC的全身治疗选择;然而,单药ICIs在晚期HCC中的客观缓解率仅为有限的15%-20%。因此,其他增强ICIs疗效或抑制其他肿瘤促进途径的联合方法可能会改善临床结果。表观遗传改变(例如染色质状态变化和非遗传DNA修饰)已被证明可驱动HCC肿瘤生长和进展及其对ICIs的反应。最近的研究在临床前和临床环境中将ICIs与表观遗传抑制剂联合使用,以治疗包括HCC在内的多种癌症。在这篇综述中,我们概述了目前用于HCC的ICI治疗方法、其成败背后的机制,以及ICIs如何与不同的表观遗传抑制剂联合使用,以提高ICIs的疗效并潜在地治疗“免疫冷”HCC。