复发/难治性急性髓系白血病新型免疫治疗策略的进展
Updates in novel immunotherapeutic strategies for relapsed/refractory AML.
作者信息
Bawek Sawyer, Gurusinghe Sayuri, Burwinkel Matthew, Przespolewski Amanda
机构信息
Department of Internal Medicine, University at Buffalo, Buffalo, NY, United States.
Leukemia Service, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States.
出版信息
Front Oncol. 2024 Dec 4;14:1374963. doi: 10.3389/fonc.2024.1374963. eCollection 2024.
Acute myeloid leukemia (AML) is a severe hematological malignancy with poor outcomes, particularly in older adults. Traditional treatment options like high-dose chemotherapy often lead to refractory or relapsed AML, with even worse outcomes. New therapies for relapsed and refractory AML are needed, and this review explores the most recent advancements in immunotherapy in AML. Checkpoint Inhibitors utilizing innate or adaptive immune targeting have shown potential to improve AML outcomes when combined with hypomethylating agents and chemotherapy. The use of adoptive cell therapy in AML demonstrates promising early data, however, there is a need for better target selection. Although early in development, both vaccine therapy as well as stimulator of interferon genes (STING) agonists have potential to enhance the innate immune response to overcome AML's immune evasion. Immunotherapy has become a promising approach for AML treatment, especially in refractory and relapsed AML, especially in patients who are not eligible for allogeneic stem cell transplants. Future research should focus on a deeper understanding of the immune microenvironment to identify the most critical targets for optimization, as well as personalized therapeutic combination strategies. Here we present a comprehensive overview of the recent developments in immunotherapy for relapsed and refractory AML.
急性髓系白血病(AML)是一种严重的血液系统恶性肿瘤,预后较差,尤其是在老年人中。像大剂量化疗这样的传统治疗方案常常导致难治性或复发性AML,预后更差。需要针对复发性和难治性AML的新疗法,本综述探讨了AML免疫疗法的最新进展。利用先天性或适应性免疫靶向的检查点抑制剂与低甲基化药物和化疗联合使用时,已显示出改善AML预后的潜力。AML中过继性细胞疗法的应用展示了有前景的早期数据,然而,需要更好地选择靶点。尽管仍处于研发早期,但疫苗疗法以及干扰素基因刺激剂(STING)激动剂都有增强先天性免疫反应以克服AML免疫逃逸的潜力。免疫疗法已成为AML治疗的一种有前景的方法,特别是在难治性和复发性AML中,尤其是在不符合异基因干细胞移植条件的患者中。未来的研究应专注于更深入地了解免疫微环境,以确定最关键的优化靶点以及个性化的治疗联合策略。在此,我们全面概述了复发性和难治性AML免疫疗法的最新进展。