Hallmarks of response, resistance, and toxicity to immune checkpoint blockade.

Hallmarks of response, resistance, and toxicity to immune checkpoint blockade.
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DOI:
10.1016/j.cell.2021.09.020
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发表时间:
2021-10-14
期刊:
影响因子:
64.5
通讯作者:
Wargo JA
Wargo JA
中科院分区:
生物学1区
文献类型:
--
作者:
Morad G;Helmink BA;Sharma P;Wargo JA

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免疫检查点阻断(ICB)在癌症治疗方面取得了前所未有的进展。然而,反应仅限于一小部分患者,免疫相关不良事件(irAEs)可能是有问题的,需要停止治疗。对宿主影响ICB反应和毒性的内在和外在因素的反复洞察是非常必要的。我们对宿主内在因素(如宿主基因组、表观基因组和免疫)影响的理解在过去十年中有了实质性的发展,对这些因素以及肿瘤和免疫的共同进化有了更深入的了解。此外,我们开始了解急性和累积暴露-宿主内部和外部(即暴露体)-对宿主生理和治疗反应的影响。这些共同代表了目前对ICB的反应、耐药性和毒性的标志。建立在这些特点上的机会是理所当然的。免疫检查点封锁已经彻底改变了癌症治疗方法,但并不是对所有人都有效。它可能引起不可接受的免疫相关不良事件,或者肿瘤可能没有反应或产生耐药性。我们开始了解其中的生物学原因。
Unprecedented advances have been made in cancer treatment with the use of immune checkpoint blockade (ICB). However, responses are limited to a subset of patients, and immune-related adverse events (irAEs) can be problematic, requiring treatment discontinuation. Iterative insights into factors intrinsic and extrinsic to the host that impact ICB response and toxicity are critically needed. Our understanding of the impact of host-intrinsic factors (such as the host genome, epigenome, and immunity) has evolved substantially over the past decade, with greater insights on these factors and on tumor and immune co-evolution. Additionally, we are beginning to understand the impact of acute and cumulative exposures--both internal and external to the host (i.e., the exposome)--on host physiology and response to treatment. Together these represent the current day hallmarks of response, resistance, and toxicity to ICB. Opportunities built on these hallmarks are duly warranted. Immune checkpoint blockade has revolutionized cancer therapeutics, but it doesn’t work for everyone. It may cause unacceptable immune-related adverse events, or tumors may fail to respond or develop resistance. We’re beginning to understand the biological reasons why.
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