Chattopadhyay Soumyadeep, Hazra Rudradeep, Mallick Arijit, Gayen Sakuntala, Roy Souvik
Department of Pharmaceutical Technology, NSHM Knowledge Campus, Kolkata-Group of Institutions, Kolkata, West Bengal 700053, India.
Department of Pharmaceutical Technology, NSHM Knowledge Campus, Kolkata-Group of Institutions, Kolkata, West Bengal 700053, India.
Biochim Biophys Acta Rev Cancer. 2024 Sep;1879(5):189170. doi: 10.1016/j.bbcan.2024.189170. Epub 2024 Aug 9.
Immunotherapy has revolutionized cancer management, with antibody-based treatments leading the charge due to their superior pharmacodynamics, including enhanced effectiveness and specificity. However, these therapies are hampered by limitations such as prolonged half-lives, poor tissue and tumor penetration, and minimal oral bioavailability. Additionally, their immunogenic nature can cause adverse effects. Consequently, the focus is shifting towards small-molecule-based immunotherapies, which potentially overcome these drawbacks. Emerging as a promising alternative, small molecules offer the benefits of therapeutic antibodies and immunomodulators, often yielding synergistic effects when combined. Recent advancements in small-molecule cancer immunotherapy are notable, featuring inhibitors, agonists, and degraders that act as immunomodulators. This article delves into the current landscape of small-molecule immunotherapy in cancer treatment, highlighting novel agents targeting key pathways such as Toll-like receptors (TLR), PD-1/PD-L1, chemokine receptors, and stimulators of interferon genes (STING). The review emphasizes newly discovered molecular entities and their modulatory roles in tumorigenesis, many of which have progressed to clinical trials, that aims to provide a comprehensive snapshot of the evolving frontier in cancer treatment, driven by small-molecule immunomodulators.
免疫疗法彻底改变了癌症治疗模式,基于抗体的治疗因其卓越的药效学特性(包括更高的有效性和特异性)而处于领先地位。然而,这些疗法受到诸多限制,如半衰期延长、组织和肿瘤穿透性差以及口服生物利用度极低。此外,它们的免疫原性可能会导致不良反应。因此,目前的重点正转向基于小分子的免疫疗法,这类疗法有可能克服上述缺点。小分子作为一种很有前景的替代方案,兼具治疗性抗体和免疫调节剂的优点,组合使用时往往会产生协同效应。小分子癌症免疫疗法的最新进展引人注目,包括作为免疫调节剂的抑制剂、激动剂和降解剂。本文深入探讨了小分子免疫疗法在癌症治疗中的现状,重点介绍了靶向关键信号通路(如Toll样受体(TLR)、PD-1/PD-L1、趋化因子受体和干扰素基因刺激因子(STING))的新型药物。该综述着重介绍了新发现的分子实体及其在肿瘤发生中的调节作用,其中许多已进入临床试验阶段,旨在全面展示由小分子免疫调节剂推动的癌症治疗前沿领域的发展现状。