Department of Functional Biology, Immunology, Universidad de Oviedo, Oviedo, Spain.
Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain.
Mol Cancer. 2023 Aug 30;22(1):142. doi: 10.1186/s12943-023-01845-4.
Recent introduction of monoclonal antibodies targeting immune checkpoints to harness antitumor immunity has revolutionized the cancer treatment landscape. The therapeutic success of immune checkpoint blockade (ICB)-based therapies mainly relies on PD-1/PD-L1 and CTLA-4 blockade. However, the limited overall responses and lack of reliable predictive biomarkers of patient´s response are major pitfalls limiting immunotherapy success. Hence, this reflects the compelling need of unveiling novel targets for immunotherapy that allow to expand the spectrum of ICB-based strategies to achieve optimal therapeutic efficacy and benefit for cancer patients. This review thoroughly dissects current molecular and functional knowledge of BTLA/HVEM axis and the future perspectives to become a target for cancer immunotherapy. BTLA/HVEM dysregulation is commonly found and linked to poor prognosis in solid and hematological malignancies. Moreover, circulating BTLA has been revealed as a blood-based predictive biomarker of immunotherapy response in various cancers. On this basis, BTLA/HVEM axis emerges as a novel promising target for cancer immunotherapy. This prompted rapid development and clinical testing of the anti-BTLA blocking antibody Tifcemalimab/icatolimab as the first BTLA-targeted therapy in various ongoing phase I clinical trials with encouraging results on preliminary efficacy and safety profile as monotherapy and combined with other anti-PD-1/PD-L1 therapies. Nevertheless, it is anticipated that the intricate signaling network constituted by BTLA/HVEM/CD160/LIGHT involved in immune response regulation, tumor development and tumor microenvironment could limit therapeutic success. Therefore, in-depth functional characterization in different cancer settings is highly recommended for adequate design and implementation of BTLA-targeted therapies to guarantee the best clinical outcomes to benefit cancer patients.
近年来,靶向免疫检查点的单克隆抗体的引入,利用了抗肿瘤免疫,彻底改变了癌症治疗领域。免疫检查点阻断(ICB)为基础的治疗的治疗成功主要依赖于 PD-1/PD-L1 和 CTLA-4 阻断。然而,患者反应的总体反应有限和缺乏可靠的预测生物标志物是限制免疫治疗成功的主要缺陷。因此,这反映了迫切需要为免疫治疗揭示新的靶点,以使基于 ICB 的策略的范围扩大,以实现癌症患者的最佳治疗效果和获益。本综述全面剖析了 BTLA/HVEM 轴的当前分子和功能知识,以及未来成为癌症免疫治疗靶点的前景。BTLA/HVEM 的失调在实体瘤和血液恶性肿瘤中常见,与预后不良有关。此外,循环 BTLA 已被揭示为各种癌症中免疫治疗反应的基于血液的预测生物标志物。在此基础上,BTLA/HVEM 轴成为癌症免疫治疗的一个新的有前途的靶点。这促使了抗 BTLA 阻断抗体 Tifcemalimab/icatolimab 的快速开发和临床试验,作为第一种针对 BTLA 的治疗方法,在各种正在进行的 I 期临床试验中取得了令人鼓舞的初步疗效和安全性,作为单一疗法和联合其他抗 PD-1/PD-L1 疗法。然而,预计 BTLA/HVEM/CD160/LIGHT 构成的复杂信号网络在免疫反应调节、肿瘤发展和肿瘤微环境中涉及,可能会限制治疗成功。因此,强烈建议在不同的癌症环境中进行深入的功能特征分析,以充分设计和实施 BTLA 靶向治疗,保证最佳的临床结果,使癌症患者受益。
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