CD73-腺苷能检查点抑制剂作为常规和先进癌症免疫疗法的有前途的联合治疗药物。

Inhibitors of the CD73-adenosinergic checkpoint as promising combinatory agents for conventional and advanced cancer immunotherapy.

机构信息

Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia at Augusta University, Medical College of Georgia, Augusta University, Augusta, GA, United States.

Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA, United States.

出版信息

Front Immunol. 2023 Jun 26;14:1212209. doi: 10.3389/fimmu.2023.1212209. eCollection 2023.

Abstract

The cell surface enzyme CD73 is increasingly appreciated as a pivotal non-redundant immune checkpoint (IC) in addition to PD-1/PD-L1 and CTLA-4. CD73 produces extracellular adenosine (eADO), which not only inhibits antitumor T cell activity via the adenosine receptor (AR) AR, but also enhances the immune inhibitory function of cancer-associated fibroblasts and myeloid cells via AR. Preclinical studies show that inhibition of the CD73-adenosinergic pathway in experimental models of many solid tumors either as a monotherapy or, more effectively, in combination with PD-1/PD-L1 or CTLA-4 IC blockades, improves antitumor immunity and tumor control. Consequently, approximately 50 ongoing phase I/II clinical trials targeting the CD73-adenosinergic IC are currently listed on https://clinicaltrials.gov. Most of the listed trials employ CD73 inhibitors or anti-CD73 antibodies alone, in combination with AR antagonists, and/or with PD-1/PD-L1 blockade. Recent evidence suggests that the distribution of CD73, AR and AR in tumor microenvironments (TME) is heterogeneous, and this distribution affects CD73-adenosinergic IC function. The new insights have implications for the optimally effective, carefully tailored approaches to therapeutic targeting of this essential IC. In the mini-review, we briefly discuss the cellular and molecular mechanisms of CD73/eADO-mediated immunosuppression during tumor progression and therapy in the spatial context of the TME. We include preclinical data regarding therapeutic CD73-eADO blockade in tumor models as well as available clinical data from completed trials that targeted CD73-adenosinergic IC with or without PD-1/PD-L1 inhibitors and discuss factors that are potentially important for optimal therapeutic outcomes in cancer patients.

摘要

细胞表面酶 CD73 除 PD-1/PD-L1 和 CTLA-4 之外,越来越被认为是一个关键的非冗余免疫检查点 (IC)。CD73 产生细胞外腺苷 (eADO),它不仅通过腺苷受体 (AR) 抑制抗肿瘤 T 细胞活性,而且通过 AR 增强肿瘤相关成纤维细胞和髓样细胞的免疫抑制功能。临床前研究表明,在许多实体瘤的实验模型中,无论是作为单一疗法还是更有效地与 PD-1/PD-L1 或 CTLA-4 IC 阻断剂联合使用,抑制 CD73-腺苷能途径均可改善抗肿瘤免疫和肿瘤控制。因此,大约有 50 项针对 CD73-腺苷能 IC 的正在进行的 I/II 期临床试验在 https://clinicaltrials.gov 上列出。列出的大多数试验单独使用 CD73 抑制剂或抗 CD73 抗体,与 AR 拮抗剂联合使用,和/或与 PD-1/PD-L1 阻断剂联合使用。最近的证据表明,CD73、AR 和 AR 在肿瘤微环境 (TME) 中的分布是异质的,这种分布影响 CD73-腺苷能 IC 功能。这些新的见解对优化有效的、精心定制的治疗方法具有重要意义,以靶向这一重要的 IC。在这篇小型综述中,我们简要讨论了 CD73/eADO 介导的免疫抑制在肿瘤进展和治疗过程中的细胞和分子机制,以及在 TME 的空间背景下。我们包括关于在肿瘤模型中进行治疗性 CD73-eADO 阻断的临床前数据,以及来自已完成试验的可用临床数据,这些试验针对 CD73-腺苷能 IC,无论是否联合使用 PD-1/PD-L1 抑制剂,并讨论了对癌症患者获得最佳治疗效果可能很重要的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b72a/10330720/6a8630b4e8f7/fimmu-14-1212209-g001.jpg

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