血液系统恶性肿瘤的免疫治疗:成就、挑战与未来前景。

Immunotherapy in hematologic malignancies: achievements, challenges and future prospects.

机构信息

Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, China.

Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease, 430022, Wuhan, China.

出版信息

Signal Transduct Target Ther. 2023 Aug 18;8(1):306. doi: 10.1038/s41392-023-01521-5.

Abstract

The immune-cell origin of hematologic malignancies provides a unique avenue for the understanding of both the mechanisms of immune responsiveness and immune escape, which has accelerated the progress of immunotherapy. Several categories of immunotherapies have been developed and are being further evaluated in clinical trials for the treatment of blood cancers, including stem cell transplantation, immune checkpoint inhibitors, antigen-targeted antibodies, antibody-drug conjugates, tumor vaccines, and adoptive cell therapies. These immunotherapies have shown the potential to induce long-term remission in refractory or relapsed patients and have led to a paradigm shift in cancer treatment with great clinical success. Different immunotherapeutic approaches have their advantages but also shortcomings that need to be addressed. To provide clinicians with timely information on these revolutionary therapeutic approaches, the comprehensive review provides historical perspectives on the applications and clinical considerations of the immunotherapy. Here, we first outline the recent advances that have been made in the understanding of the various categories of immunotherapies in the treatment of hematologic malignancies. We further discuss the specific mechanisms of action, summarize the clinical trials and outcomes of immunotherapies in hematologic malignancies, as well as the adverse effects and toxicity management and then provide novel insights into challenges and future directions.

摘要

血液系统恶性肿瘤的免疫细胞起源为理解免疫应答和免疫逃逸的机制提供了独特的途径,从而加速了免疫疗法的进展。已经开发了几类免疫疗法,并正在临床试验中进一步评估其治疗血液癌症的效果,包括干细胞移植、免疫检查点抑制剂、抗原靶向抗体、抗体药物偶联物、肿瘤疫苗和过继细胞疗法。这些免疫疗法已显示出在难治性或复发性患者中诱导长期缓解的潜力,并在癌症治疗方面带来了巨大的临床成功,改变了范式。不同的免疫治疗方法各有优势,但也存在需要解决的缺点。为了向临床医生提供有关这些革命性治疗方法的及时信息,全面审查提供了免疫疗法在血液系统恶性肿瘤治疗中的应用和临床注意事项的历史观点。在这里,我们首先概述了在理解各种类型的免疫疗法在血液系统恶性肿瘤治疗中的应用方面取得的最新进展。我们进一步讨论了具体的作用机制,总结了免疫疗法在血液系统恶性肿瘤中的临床试验和结果,以及不良反应和毒性管理,然后对挑战和未来方向提出了新的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c1a/10435569/3b0093169d5b/41392_2023_1521_Fig1_HTML.jpg

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