摘要
免疫检查点是免疫系统的重要分子和通路,具有控制免疫反应以免破坏体内健康细胞的明确作用。它们包括抑制性受体和配体,它们检查免疫系统对大多数癌症的识别。当 T 细胞表面称为免疫检查点蛋白的蛋白质识别癌细胞上的伴侣蛋白并与其结合,向 T 细胞发送制动信号以逃避免疫攻击时,就会发生这种情况。然而,称为免疫检查点抑制剂的药物会阻止检查点蛋白与其伴侣蛋白结合,从而抑制制动信号被发送至 T 细胞。这最终使 T 细胞能够破坏癌细胞并仲裁强大的肿瘤消退。许多此类抑制剂已经获得批准并处于不同的开发阶段。充分说明的抑制检查点包括细胞毒性 T 淋巴细胞相关分子 4(CTLA-4)、进程性细胞死亡受体 1(PD-1)和进程性细胞死亡配体 1(PD-L1)。尽管许多阻断这些检查点的分子已显示出治疗许多恶性肿瘤的希望,但这些治疗方案在大多数患者的免疫反应方面取得的成功有限。在此背景下,探索新途径和下一代抑制剂成为开发反应更灵敏、更有效的免疫检查点疗法的当务之急。由于免疫检查点途径机制方面的复杂生物学和未探索的模糊性,新药活性概况的分析是艰苦研究的主题。我们在此报告了开发新的抑制途径和潜在疗法的最新进展,并根据它们的优点描述了发展。此外,还讨论了开发有效的检查点疗法所面临的挑战和即将到来的机会。
关键词: 免疫检查点通路,免疫疗法,肿瘤微环境,细胞毒性T淋巴细胞,CTLA-4,PD-1,PD-L1。
[http://dx.doi.org/10.1016/j.semcancer.2019.06.021]
[http://dx.doi.org/10.1002/eji.201646875] [PMID: 28393361]
[http://dx.doi.org/10.11569/wcjd.v28.i17.857]
[http://dx.doi.org/10.1016/j.intimp.2018.06.001] [PMID: 29990692]
[http://dx.doi.org/10.1002/jcp.27172] [PMID: 30191996]
[http://dx.doi.org/10.2174/1874210601812010455] [PMID: 29988281]
[http://dx.doi.org/10.1146/annurev-cancerbio-030518-055552]
[http://dx.doi.org/10.1002/adhm.201800424] [PMID: 29978565]
[http://dx.doi.org/10.1158/2159-8290.CD-18-0367]
[http://dx.doi.org/10.1016/j.immuni.2016.06.001]
[http://dx.doi.org/10.1186/s13046-018-0937-6]
[http://dx.doi.org/10.1051/medsci/2019073] [PMID: 31038115]
[http://dx.doi.org/10.1016/j.bj.2019.09.002] [PMID: 31783990]
[http://dx.doi.org/10.1038/d41586-018-06751-0] [PMID: 30279600]
[http://dx.doi.org/10.4149/BLL_2019_002] [PMID: 30685987]
[http://dx.doi.org/10.1016/j.cell.2018.11.006] [PMID: 30500529]
[http://dx.doi.org/10.1186/s13046-019-1259-z]
[http://dx.doi.org/10.1016/j.clinthera.2015.02.018] [PMID: 25823918]
[http://dx.doi.org/10.1038/nrclinonc.2016.58] [PMID: 27141885]
[http://dx.doi.org/10.1002/phar.1643] [PMID: 26497482]
[http://dx.doi.org/10.1097/COC.0000000000000239] [PMID: 26558876]
[http://dx.doi.org/10.1186/s12935-021-01763-9]
[http://dx.doi.org/10.1002/eji.1830101006] [PMID: 6448746]
[http://dx.doi.org/10.1006/cimm.1998.1287] [PMID: 9636688]
[http://dx.doi.org/10.1056/NEJMoa1302369] [PMID: 23724867]
[http://dx.doi.org/10.1182/blood-2007-09-111781] [PMID: 18003886]
[http://dx.doi.org/10.1186/s12929-019-0592-z]
[http://dx.doi.org/10.4161/19420862.2015.989042] [PMID: 25529996]
[http://dx.doi.org/10.1016/S1543-2912(13)60114-9] [PMID: 18632429]
[http://dx.doi.org/10.1038/s41591-021-01623-z] [PMID: 35027754]
[http://dx.doi.org/10.1016/j.cell.2021.09.020] [PMID: 34624224]
[http://dx.doi.org/10.1038/s41467-020-18742-9] [PMID: 33009409]
[http://dx.doi.org/10.1186/s13045-021-01056-8]
[http://dx.doi.org/10.1016/j.ejca.2019.04.035]
[http://dx.doi.org/10.3389/fphar.2021.681320] [PMID: 34025438]
[http://dx.doi.org/10.3389/fonc.2021.562315] [PMID: 33937012]
[http://dx.doi.org/10.1016/j.ccell.2015.03.001] [PMID: 25858804]
[http://dx.doi.org/10.1038/ni0702-611] [PMID: 12087419]
[http://dx.doi.org/10.1126/science.aaa8172]
[http://dx.doi.org/10.1038/nrc3239] [PMID: 22437870]
[http://dx.doi.org/10.1126/science.aar4060]
[http://dx.doi.org/10.1200/JCO.2014.59.4358] [PMID: 25605845]
[http://dx.doi.org/10.1093/annonc/mdx686] [PMID: 29069302]
[http://dx.doi.org/10.3389/fimmu.2018.01909]
[http://dx.doi.org/10.1016/j.cell.2016.02.065] [PMID: 26997480]
[http://dx.doi.org/10.1038/s41598-017-01000-2]
[http://dx.doi.org/10.1038/nature13954] [PMID: 25428505]
[http://dx.doi.org/10.1038/nrc.2016.36] [PMID: 27079802]
[http://dx.doi.org/10.1016/j.tips.2019.11.003] [PMID: 31836191]
[http://dx.doi.org/10.1182/blood-2017-06-741033]
[http://dx.doi.org/10.1146/annurev.immunol.19.1.565]
[http://dx.doi.org/10.1111/j.1600-065X.2009.00770.x] [PMID: 19426212]
[http://dx.doi.org/10.1128/MCB.25.21.9543-9553.2005] [PMID: 16227604]
[http://dx.doi.org/10.1016/S1470-2045(09)70334-1] [PMID: 20004617]
[http://dx.doi.org/10.1158/1078-0432.CCR-09-2033] [PMID: 20086001]
[http://dx.doi.org/10.1186/1479-5876-9-196] [PMID: 22077981]
[http://dx.doi.org/10.1158/1078-0432.CCR-18-2509] [PMID: 30291135]
[http://dx.doi.org/10.2147/OTT.S4833]
[http://dx.doi.org/10.1155/2021/6662344] [PMID: 34122547]
[http://dx.doi.org/10.21037/atm.2017.06.11] [PMID: 29114543]
[http://dx.doi.org/10.3389/fimmu.2019.02298]
[http://dx.doi.org/10.1084/jem.192.7.1027] [PMID: 11015443]
[http://dx.doi.org/10.1016/j.immuni.2018.03.014]
[http://dx.doi.org/10.1038/s41590-020-0620-x] [PMID: 32152508]
[http://dx.doi.org/10.1093/intimm/8.5.765] [PMID: 8671665]
[http://dx.doi.org/10.3389/fimmu.2020.584626]
[PMID: 32266087]
[http://dx.doi.org/10.3389/fimmu.2018.02737] [PMID: 30542345]
[http://dx.doi.org/10.1111/j.1600-065X.2010.00923.x]
[http://dx.doi.org/10.1073/pnas.1718217115] [PMID: 29654146]
[http://dx.doi.org/10.1158/0008-5472.CAN-03-3259] [PMID: 14871849]
[http://dx.doi.org/10.1016/j.imlet.2007.10.010]
[http://dx.doi.org/10.1016/B978-0-12-800763-1.00015-4]
[http://dx.doi.org/10.1016/S0960-9822(02)00506-7] [PMID: 8723343]
[http://dx.doi.org/10.1084/jem.182.2.289] [PMID: 7543133]
[http://dx.doi.org/10.3389/fimmu.2019.01242]
[http://dx.doi.org/10.1038/s41598-020-65666-x] [PMID: 32493990]
[http://dx.doi.org/10.3390/cancers12113285]
[http://dx.doi.org/10.1186/s12885-019-6499-y] [PMID: 31914969]
[http://dx.doi.org/10.1073/pnas.1822001116] [PMID: 31028147]
[http://dx.doi.org/10.1002/eji.202048960] [PMID: 33684223]
[http://dx.doi.org/10.1038/70932] [PMID: 10581077]
[http://dx.doi.org/10.1038/85330] [PMID: 11224527]
[http://dx.doi.org/10.1084/jem.20051776] [PMID: 16606670]
[http://dx.doi.org/10.1084/jem.20112741] [PMID: 22641383]
[http://dx.doi.org/10.1126/science.aaf1292] [PMID: 28280247]
[http://dx.doi.org/10.1016/j.celrep.2018.03.026] [PMID: 29617671]
[http://dx.doi.org/10.1183/13993003.congress-2020.1692]
[http://dx.doi.org/10.2146/ajhp140768] [PMID: 26843495]
[http://dx.doi.org/10.1586/14737140.2015.1074862] [PMID: 26313415]
[http://dx.doi.org/10.1097/MD.0000000000013804] [PMID: 30633154]
[http://dx.doi.org/10.24304/kjcp.2017.28.1.65]
[http://dx.doi.org/10.1634/theoncologist.2014-0422] [PMID: 26069281]
[http://dx.doi.org/10.1056/NEJMoa1104621] [PMID: 21639810]
[http://dx.doi.org/10.1002/cam4.732] [PMID: 27167347]
[http://dx.doi.org/10.1016/S1470-2045(18)30700-9] [PMID: 30361170]
[http://dx.doi.org/10.1136/jitc-2019-000391] [PMID: 32503946]
[http://dx.doi.org/10.1093/annonc/mdu438.34]
[http://dx.doi.org/10.1200/JCO.2016.71.8023] [PMID: 28671856]
[http://dx.doi.org/10.1158/1078-0432.CCR-16-0663] [PMID: 28235882]
[http://dx.doi.org/10.1158/1078-0432.CCR-16-0664] [PMID: 28179454]
[http://dx.doi.org/10.1111/imm.12788]
[http://dx.doi.org/10.1016/B978-0-323-54945-5.00032-1]
[http://dx.doi.org/10.1016/B978-0-323-35762-3.00102-5]
[http://dx.doi.org/10.1517/14712598.2014.942637] [PMID: 25056108]
[http://dx.doi.org/10.3389/fimmu.2017.01597]
[http://dx.doi.org/10.4049/jimmunol.1401572] [PMID: 25281753]
[http://dx.doi.org/10.1080/2162402X.2017.1364828]
[http://dx.doi.org/10.1186/s12935-021-01946-4]
[http://dx.doi.org/10.1146/annurev.immunol.26.021607.090331] [PMID: 18173375]
[http://dx.doi.org/10.1186/s13045-019-0779-5] [PMID: 31488176]
[http://dx.doi.org/10.1200/jco.2014.32.15_suppl.3064]
[http://dx.doi.org/10.1200/jco.2013.31.15_suppl.3000]
[http://dx.doi.org/10.1200/jco.2014.32.15_suppl.3002]
[http://dx.doi.org/10.1200/jco.2014.32.15_suppl.5011]
[http://dx.doi.org/10.1038/s41577-020-0306-5]
[http://dx.doi.org/10.1038/s41422-020-0343-4]
[http://dx.doi.org/10.4110/in.2020.20.e3]
[http://dx.doi.org/10.1186/s12943-019-1091-2]
[http://dx.doi.org/10.3389/fimmu.2020.615317]
[http://dx.doi.org/10.1080/2162402X.2021.1912892] [PMID: 33996265]
[http://dx.doi.org/10.1111/cei.13407] [PMID: 31828774]
[http://dx.doi.org/10.1136/jitc-2020-000957] [PMID: 32900861]
[http://dx.doi.org/10.1080/2162402X.2018.1466769] [PMID: 30221069]
[http://dx.doi.org/10.1038/s41577-019-0224-6]
[http://dx.doi.org/10.1084/jem.20100637] [PMID: 20819923]
[http://dx.doi.org/10.1158/1535-7163.MCT-16-0761] [PMID: 28679835]
[http://dx.doi.org/10.3389/fimmu.2021.701006] [PMID: 34349762]
[http://dx.doi.org/10.3389/FIMMU.2016.00304/BIBTEX] [PMID: 27559335]
[http://dx.doi.org/10.1073/pnas.092576699] [PMID: 11983910]
[http://dx.doi.org/10.1186/s13045-020-00917-y] [PMID: 32600443]
[http://dx.doi.org/10.3389/fonc.2021.658488] [PMID: 33937071]
[http://dx.doi.org/10.3389/fimmu.2021.676181]
[http://dx.doi.org/10.1002/eji.1830250949] [PMID: 7589152]
[http://dx.doi.org/10.1158/0008-5472.CAN-13-2690] [PMID: 24769443]
[http://dx.doi.org/10.1111/imr.12520]
[http://dx.doi.org/10.3389/fonc.2020.601661]
[http://dx.doi.org/10.1016/j.ccell.2014.10.018] [PMID: 25465800]
[http://dx.doi.org/10.1172/JCI80445] [PMID: 25866972]
[http://dx.doi.org/10.4049/jimmunol.1003081] [PMID: 21199897]
[http://dx.doi.org/10.1158/1078-0432.CCR-12-2064] [PMID: 23460534]
[http://dx.doi.org/10.1016/j.celrep.2016.05.058] [PMID: 27292635]
[http://dx.doi.org/10.1158/1078-0432.CCR-21-1466]
[http://dx.doi.org/10.1158/1078-0432.CCR-21-0557] [PMID: 33846198]
[http://dx.doi.org/10.1158/1078-0432.CCR-20-4706] [PMID: 33472912]
[http://dx.doi.org/10.1158/1078-0432.CCR-20-3407] [PMID: 33139264]
[http://dx.doi.org/10.1056/NEJMoa1809615] [PMID: 30345906]
[http://dx.doi.org/10.1136/esmoopen-2020-001112]
[http://dx.doi.org/10.1097/01.COT.0000527191.27807.ab]
[http://dx.doi.org/10.1158/1078-0432.CCR-18-4070] [PMID: 30787022]
[http://dx.doi.org/10.1634/theoncologist.2018-0084] [PMID: 30541754]
[http://dx.doi.org/10.1634/theoncologist.2017-0004] [PMID: 28438889]
[http://dx.doi.org/10.1634/theoncologist.2016-0476] [PMID: 28232599]
[http://dx.doi.org/10.1056/NEJMoa1414428] [PMID: 25891304]
[http://dx.doi.org/10.1080/14737159.2018.1440209] [PMID: 29430978]
[http://dx.doi.org/10.1186/s13046-020-01749-x]
[http://dx.doi.org/10.3389/fonc.2020.585311]
[http://dx.doi.org/10.1056/NEJMra1703481] [PMID: 29320654]
[http://dx.doi.org/10.1016/j.annonc.2020.03.285] [PMID: 32194150]
[http://dx.doi.org/10.3389/fimmu.2017.01547]
[http://dx.doi.org/10.3389/fimmu.2021.732933]
[http://dx.doi.org/10.1007/s42242-021-00150-7]
[http://dx.doi.org/10.1016/j.stem.2015.12.005]
[http://dx.doi.org/10.1016/j.stem.2007.05.012] [PMID: 18371333]
[http://dx.doi.org/10.3390/ijms19040936]
[http://dx.doi.org/10.1038/s41576-018-0051-9] [PMID: 30228295]
[http://dx.doi.org/10.1038/s41580-020-0259-3]
[http://dx.doi.org/10.1016/j.it.2016.01.004]
[http://dx.doi.org/10.1038/s41591-018-0014-x] [PMID: 29686425]
[http://dx.doi.org/10.3389/fimmu.2020.00940]
[http://dx.doi.org/10.1172/JCI80005] [PMID: 26168215]
[http://dx.doi.org/10.1159/000319928] [PMID: 32841942]
[http://dx.doi.org/10.1080/25785826.2020.1785654] [PMID: 32643578]
[http://dx.doi.org/10.1155/2019/5245034]
[http://dx.doi.org/10.1016/bs.ai.2015.12.005]
[http://dx.doi.org/10.1007/s11912-019-0851-x] [PMID: 31696332]
[http://dx.doi.org/10.1189/jlb.5RI0116-013RR] [PMID: 27256570]
[http://dx.doi.org/10.3389/fimmu.2019.00999]
[http://dx.doi.org/10.1158/1078-0432.CCR-15-1849] [PMID: 27084739]
[http://dx.doi.org/10.1038/cddis.2015.162]