Strategies for treating the cold tumors of cholangiocarcinoma: core concepts and future directions.

IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Clinical and Experimental Medicine Pub Date : 2024-08-14 DOI:10.1007/s10238-024-01460-7
GuanBo Zhang, JinSong Li, Gang Li, Jie Zhang, Zhi Yang, Lin Yang, ShiJie Jiang, JiaXing Wang
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Abstract

Cholangiocarcinoma (CCA) is a rare type of digestive tract cancer originating from the epithelial cells of the liver and biliary tract. Current treatment modalities for CCA, such as chemotherapy and radiation therapy, have demonstrated limited efficacy in enhancing survival rates. Despite the revolutionary potential of immunotherapy in cancer management, its application in CCA remains restricted due to the minimal infiltration of immune cells in these tumors, rendering them cold and unresponsive to immune checkpoint inhibitors (ICIs). Cancer cells within cold tumors deploy various mechanisms for evading immune attack, thus impeding clinical management. Recently, combination immunotherapy has become increasingly essential to comprehend the mechanisms underlying cold tumors to enhance a deficient antitumor immune response. Therefore, a thorough understanding of the knowledge on the combination immunotherapy of cold CCA is imperative to leverage the benefits of immunotherapy in treating patients. Moreover, gut microbiota plays an essential role in the immunotherapeutic responses in CCA. In this review, we summarize the current concepts of immunotherapy in CCA and clarify the intricate dynamics within the tumor immune microenvironment (TIME) of CCA. We also delve into the evasion mechanisms employed by CCA tumors against the anti-tumor immune responses. The context of combination immunotherapies in igniting cold tumors of CCA and the critical function of gut microbiota in prompting immune responses have also been annotated. Furthermore, we have proposed future directions in the realm of CCA immunotherapy, aiming to improve the clinical prognosis of CCA patients.

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治疗胆管癌冷肿瘤的策略:核心概念和未来方向。
胆管癌(CCA)是一种罕见的消化道癌症,起源于肝脏和胆道的上皮细胞。目前治疗 CCA 的方法,如化疗和放疗,在提高生存率方面效果有限。尽管免疫疗法在癌症治疗中具有革命性的潜力,但其在 CCA 中的应用仍然受到限制,原因是这些肿瘤中的免疫细胞浸润极少,使其成为冷肿瘤,对免疫检查点抑制剂(ICIs)反应迟钝。冷性肿瘤中的癌细胞采用各种机制逃避免疫攻击,从而阻碍了临床治疗。近来,联合免疫疗法对理解冷冻瘤的内在机制以增强不足的抗肿瘤免疫反应变得越来越重要。因此,全面了解冷性 CCA 的联合免疫疗法知识,对于充分利用免疫疗法的优势治疗患者至关重要。此外,肠道微生物群在 CCA 的免疫治疗反应中起着至关重要的作用。在这篇综述中,我们总结了当前 CCA 免疫疗法的概念,并阐明了 CCA 肿瘤免疫微环境 (TIME) 中错综复杂的动态变化。我们还深入探讨了 CCA 肿瘤对抗肿瘤免疫反应的规避机制。我们还注释了联合免疫疗法点燃 CCA 冷肿瘤的背景,以及肠道微生物群在促进免疫反应中的关键功能。此外,我们还提出了 CCA 免疫疗法的未来发展方向,旨在改善 CCA 患者的临床预后。
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来源期刊
Clinical and Experimental Medicine
Clinical and Experimental Medicine 医学-医学:研究与实验
CiteScore
4.80
自引率
2.20%
发文量
159
审稿时长
2.5 months
期刊介绍: Clinical and Experimental Medicine (CEM) is a multidisciplinary journal that aims to be a forum of scientific excellence and information exchange in relation to the basic and clinical features of the following fields: hematology, onco-hematology, oncology, virology, immunology, and rheumatology. The journal publishes reviews and editorials, experimental and preclinical studies, translational research, prospectively designed clinical trials, and epidemiological studies. Papers containing new clinical or experimental data that are likely to contribute to changes in clinical practice or the way in which a disease is thought about will be given priority due to their immediate importance. Case reports will be accepted on an exceptional basis only, and their submission is discouraged. The major criteria for publication are clarity, scientific soundness, and advances in knowledge. In compliance with the overwhelmingly prevailing request by the international scientific community, and with respect for eco-compatibility issues, CEM is now published exclusively online.
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