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克服非小细胞肺癌免疫治疗耐药的策略——针对癌细胞

Developing Effective Strategies to Overcome Immunotherapy Resistance in Non-Small Cell Lung Cancer by Directly Targeting Cancer Cells

  • 摘要: 虽然开发新的点对点的药物是克服耐药的关键和热门的研究领域,但成功研发新的药物困难重重。因此,面对晚期NSCLC患者的热切期待,结合临床前、临床和真实世界证据,设计各种联合治疗策略,如放疗、化疗、靶向治疗、抗体药物偶联物、溶瘤病毒和细胞治疗,可能是一个明智和现实的选择。免疫治疗的耐药涉及身体内几乎所有的细胞类型,最主要的是癌细胞本身和参与免疫监视的T细胞。限于篇幅,本文主要关注各种直接消除癌细胞的联合策略的进展和存在挑战。值得注意的是,我们强调治疗目标的重新定位——从主要关注消除癌细胞(如通过化疗和放疗)转向充分发挥免疫调节功能,以克服免疫检查点抑制剂的耐药。

     

    Abstract: The development of novel point-to-point drugs targeting resistance mechanisms is a critical and popular research field; nevertheless, success remains challenging. Therefore, given the short survival time and heightened expectations of patients with advanced NSCLC, the design of various combination therapy strategies––integrating preclinical, clinical, and real-world evidence (such as radiotherapy, chemotherapy, targeted therapy, antibody–drug conjugates, oncolytic viruses, and cell therapy)––may be a wise and practical choice to address the disease. Resistance to immunotherapy involves almost all cell types in the body, primarily cancer cells and T cells involved in immune surveillance. As a result of space limitations, this article focuses on the progress and challenges of various combined strategies for directly eliminating cancer cells. We also emphasize the realignment of treatment goals, shifting from primarily focusing on eliminating cancer cells (via chemotherapy and radiotherapy) to fully utilizing immune regulation to overcome resistance to immune checkpoint inhibitors.

     

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