Barjij Imad, Meliani Meryem
Department of Medical Oncology, Faculty of Medicine and Pharmacy of Rabat, National Institute of Oncology, Ibn Sina University Hospital, Mohammed V University, Rabat, MAR.
Department of Medical Oncology, Regional Oncology Center of Laâyoune, Regional Hospital Center of Laâyoune, Laâyoune, MAR.
Cureus. 2025 Jun 11;17(6):e85776. doi: 10.7759/cureus.85776. eCollection 2025 Jun.
Immunogenic cell death (ICD) represents a distinct form of regulated cell death that triggers robust antitumor immune responses through the release of damage-associated molecular patterns (DAMPs) such as calreticulin (CRT), extracellular adenosine triphosphate (ATP), and high-mobility group box 1 protein (HMGB1). While ICD has emerged as a promising strategy to enhance cancer immunotherapy, its integration into therapeutic regimens remains fragmented. This systematic review aimed to synthesize the experimental evidence on ICD-inducing treatments in solid tumors and assess the convergence of mechanistic pathways and combination strategies. A comprehensive literature search identified 14 eligible studies published between 2010 and 2025, including preclinical in vitro and in vivo investigations of radiotherapy, chemotherapy, photodynamic therapy (PDT), oncolytic virotherapy, and redox- or lysosome-targeted agents. Despite mechanistic diversity, most interventions converged on shared cellular stress responses, notably endoplasmic reticulum (ER) stress and reactive oxygen species (ROS) production, leading to DAMP exposure and dendritic cell maturation. Eight studies incorporated immune checkpoint inhibitors, revealing synergistic antitumor effects and immune memory enhancement. While most studies demonstrated in vivo efficacy, two relied solely on in vitro or ex vivo models. The risk of bias was low in the majority of cases. Collectively, the evidence supports ICD as a central immunologic interface capable of transforming cytotoxic therapies into immune-activating treatments. Future clinical research should prioritize ICD biomarker validation, optimization of treatment timing, and development of personalized ICD-based combination regimens. These findings reinforce the potential of ICD to serve as a unifying framework in the next generation of cancer immunotherapies.
免疫原性细胞死亡(ICD)是一种独特的程序性细胞死亡形式,通过释放钙网蛋白(CRT)、细胞外三磷酸腺苷(ATP)和高迁移率族蛋白B1(HMGB1)等损伤相关分子模式(DAMP)触发强大的抗肿瘤免疫反应。虽然ICD已成为增强癌症免疫治疗的一种有前景的策略,但其纳入治疗方案仍较为零散。本系统评价旨在综合实体瘤中诱导ICD治疗的实验证据,并评估机制途径和联合策略的趋同性。全面的文献检索确定了2010年至2025年间发表的14项符合条件的研究,包括放疗、化疗、光动力疗法(PDT)、溶瘤病毒疗法以及氧化还原或溶酶体靶向药物的临床前体外和体内研究。尽管机制多样,但大多数干预措施都集中在共同的细胞应激反应上,特别是内质网(ER)应激和活性氧(ROS)生成,导致DAMP暴露和树突状细胞成熟。八项研究纳入了免疫检查点抑制剂,显示出协同抗肿瘤作用和免疫记忆增强。虽然大多数研究证明了体内疗效,但两项研究仅依赖体外或离体模型。大多数情况下偏倚风险较低。总体而言,证据支持ICD作为一个核心免疫界面,能够将细胞毒性疗法转化为免疫激活疗法。未来的临床研究应优先验证ICD生物标志物、优化治疗时机,并开发基于ICD的个性化联合方案。这些发现强化了ICD作为下一代癌症免疫疗法统一框架的潜力。