Ge Yuli, Zhou Qiong, Pan Fan, Wang Rui
Department of Medical Oncology, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, People's Republic of China.
Department of Medical Oncology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210093, People's Republic of China.
Int J Nanomedicine. 2025 Feb 25;20:2371-2394. doi: 10.2147/IJN.S505539. eCollection 2025.
Lung cancer is the leading cause of cancer-related mortality globally, with non-small cell lung cancer (NSCLC) constituting 85% of cases. Immune checkpoint inhibitors (ICIs) represented by anti-programmed cell death protein 1 (PD-1)/ programmed cell death ligand 1 (PD-L1) have emerged as a promising frontier in cancer treatment, effectively extending the survival of patients with NSCLC. However, the efficacy of ICIs exhibits significant variability across diverse patient populations, with a substantial proportion showing poor responsiveness and acquired resistance in those initially responsive to ICIs treatments. With the advancement of nanotechnology, nanoparticles offer unique advantages in tumor immunotherapy, including high permeability and prolonged retention(EPR) effects, enhanced drug delivery and stability, and modulation of the inflammatory tumor microenvironment(TME). This review summarizes the mechanisms of resistance to ICIs in NSCLC, focusing on tumor antigens loss and defective antigen processing and presentation, failure T cell priming, impaired T cell migration and infiltration, immunosuppressive TME, and genetic mutations. Furthermore, we discuss how nanoparticles, through their intrinsic properties such as the EPR effect, active targeting effect, shielding effect, self-regulatory effect, and synergistic effect, can potentiate the efficacy of ICIs and reverse resistance. In conclusion, nanoparticles serve as a robust platform for ICIs-based NSCLC therapy, aiding in overcoming resistance challenges.
肺癌是全球癌症相关死亡的主要原因,其中非小细胞肺癌(NSCLC)占病例的85%。以抗程序性细胞死亡蛋白1(PD-1)/程序性细胞死亡配体1(PD-L1)为代表的免疫检查点抑制剂(ICIs)已成为癌症治疗中一个有前景的前沿领域,有效延长了NSCLC患者的生存期。然而,ICIs的疗效在不同患者群体中表现出显著差异,很大一部分患者对ICIs治疗最初有反应,但随后反应不佳并产生获得性耐药。随着纳米技术的发展,纳米颗粒在肿瘤免疫治疗中具有独特优势,包括高通透性和长循环(EPR)效应、增强的药物递送和稳定性,以及对炎症性肿瘤微环境(TME)的调节。本文综述了NSCLC中对ICIs耐药的机制,重点关注肿瘤抗原丢失、抗原加工和呈递缺陷、T细胞启动失败、T细胞迁移和浸润受损、免疫抑制性TME以及基因突变。此外,我们还讨论了纳米颗粒如何通过其诸如EPR效应、主动靶向效应、屏蔽效应、自我调节效应和协同效应等固有特性来增强ICIs的疗效并逆转耐药。总之,纳米颗粒是基于ICIs的NSCLC治疗的强大平台,有助于克服耐药挑战。
Crit Rev Oncol Hematol. 2025-5
Int Immunopharmacol. 2025-5-16
J Thorac Oncol. 2019-2-6
J Hematol Oncol. 2024-7-19
J Hematol Oncol. 2024-4-2
Adv Drug Deliv Rev. 2024-3
ACS Appl Mater Interfaces. 2023-7-5
Mol Cancer. 2023-6-13