Image-guided intratumoral immunotherapy: Developing a clinically practical technology.
Image-guided intratumoral immunotherapy: Developing a clinically practical technology.
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DOI：
10.1016/j.addr.2022.114505
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发表时间：
2022-10
影响因子：
16.1
通讯作者：
中科院分区：
文献类型：
--
作者：
免疫疗法已经彻底改变了当代肿瘤学领域，在一系列癌症类型中可能产生持久的反应。然而，由于大量的免疫抑制屏障，大多数癌症患者对免疫治疗没有反应。克服这些障碍和提高全身免疫治疗效果的努力引起了人们对局部肿瘤内递送免疫刺激剂以激活局部免疫反应并随后驱动全身肿瘤免疫的兴趣。虽然许多候选治疗方法的临床评估正在进行中，但由于缺乏局部给药的影像学确认，肿瘤内药物分布不足以及需要反复注射，阻碍了发展。聚合物给药系统已被广泛用作图像引导和药物控制释放的平台，有望为肿瘤内免疫佐剂的递送和转移性癌症患者原位癌症疫苗的开发带来希望。在本文中，我们探讨了肿瘤内给药领域的现状和优化药物控释的方法，以及优化临床图像引导给药（特别是CT和超声）给药设计的实际考虑。
Immunotherapy has revolutionized the contemporary oncology landscape, with durable responses possible across a range of cancer types. However, the majority of cancer patients do not respond to immunotherapy due to numerous immunosuppressive barriers. Efforts to overcome these barriers and increase systemic immunotherapy efficacy have sparked interest in the local intratumoral delivery of immune stimulants to activate the local immune response and subsequently drive systemic tumor immunity. While clinical evaluation of many therapeutic candidates is ongoing, development is hindered by a lack of imaging confirmation of local delivery, insufficient intratumoral drug distribution, and a need for repeated injections. The use of polymeric drug delivery systems, which have been widely used as platforms for both image guidance and controlled drug release, holds promise for delivery of intratumoral immunoadjuvants and the development of an in situ cancer vaccine for patients with metastatic cancer. In this review, we explore the current state of the field for intratumoral delivery and methods for optimizing controlled drug release, as well as practical considerations for drug delivery design to be optimized for clinical image guided delivery particularly by CT and ultrasound.
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