DeRyckere Deborah, Huelse Justus M, Earp H Shelton, Graham Douglas K
Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Department of Paediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Nat Rev Clin Oncol. 2023 Nov;20(11):755-779. doi: 10.1038/s41571-023-00813-7. Epub 2023 Sep 4.
Novel treatment approaches are needed to overcome innate and acquired mechanisms of resistance to current anticancer therapies in cancer cells and the tumour immune microenvironment. The TAM (TYRO3, AXL and MERTK) family receptor tyrosine kinases (RTKs) are potential therapeutic targets in a wide range of cancers. In cancer cells, TAM RTKs activate signalling pathways that promote cell survival, metastasis and resistance to a variety of chemotherapeutic agents and targeted therapies. TAM RTKs also function in innate immune cells, contributing to various mechanisms that suppress antitumour immunity and promote resistance to immune-checkpoint inhibitors. Therefore, TAM antagonists provide an unprecedented opportunity for both direct and immune-mediated therapeutic activity provided by inhibition of a single target, and are likely to be particularly effective when used in combination with other cancer therapies. To exploit this potential, a variety of agents have been designed to selectively target TAM RTKs, many of which have now entered clinical testing. This Review provides an essential guide to the TAM RTKs for clinicians, including an overview of the rationale for therapeutic targeting of TAM RTKs in cancer cells and the tumour immune microenvironment, a description of the current preclinical and clinical experience with TAM inhibitors, and a perspective on strategies for continued development of TAM-targeted agents for oncology applications.
需要新的治疗方法来克服癌细胞和肿瘤免疫微环境中对当前抗癌疗法的固有和获得性耐药机制。TAM(TYRO3、AXL和MERTK)家族受体酪氨酸激酶(RTK)是多种癌症潜在的治疗靶点。在癌细胞中,TAM RTK激活促进细胞存活、转移以及对多种化疗药物和靶向治疗产生耐药性的信号通路。TAM RTK在先天免疫细胞中也发挥作用,参与抑制抗肿瘤免疫和促进对免疫检查点抑制剂耐药的多种机制。因此,TAM拮抗剂为通过抑制单一靶点提供直接和免疫介导的治疗活性带来了前所未有的机会,并且与其他癌症疗法联合使用时可能特别有效。为了利用这一潜力,已设计出多种药物选择性靶向TAM RTK,其中许多现已进入临床试验。本综述为临床医生提供了一份关于TAM RTK的重要指南,包括概述在癌细胞和肿瘤免疫微环境中靶向TAM RTK进行治疗的基本原理,描述TAM抑制剂目前的临床前和临床经验,并展望TAM靶向药物在肿瘤学应用中持续开发的策略。