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Unveiling Cuproptosis: Mechanistic insights, roles, and leading advances in oncology 揭开杯状突变的神秘面纱:肿瘤学的机制认识、作用和领先进展
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-12 DOI: 10.1016/j.bbcan.2024.189180

Copper, a vital micronutrient, performs essential functions in numerous biological settings. Its disrupted metabolism is implicated in both the initiation of tumors and therapeutic interventions for cancer, underscoring the critical necessity of preserving copper homeostasis. Cuproptosis, a regulated cell death (RCD) modulated by copper, is activated in response to elevated copper concentrations, prompting an investigation into its implication in oncogenesis. Within this review, an exploration is conducted into copper dynamics and homeostasis maintenance within cells. Furthermore, it delves into the mechanisms underlying cuproptosis and its interplay with signaling pathways implicated in cancer. The potential synergy between cuproptosis and ferroptosis and its impact on tumor immunomodulation is discussed. Additionally, promising avenues for addressing cuproptosis in cancer involve assessing the utility of copper chelators and ionophores. By addressing pressing questions surrounding cuproptosis and outlining its pivotal role in cancer pathogenesis and treatment, this review propounds targeting cuproptosis as a promising frontier in antitumor therapy, potentially revolutionizing cancer treatment strategies.

铜是一种重要的微量营养元素,在多种生物环境中发挥着重要功能。铜代谢紊乱与肿瘤的诱发和癌症的治疗干预都有关系,这突出表明了保持铜平衡的重要性。铜中毒(Cuproptosis)是一种受铜调节的细胞死亡(RCD),在铜浓度升高时会被激活,这促使人们对其在肿瘤发生中的作用进行研究。本综述探讨了铜在细胞内的动态变化和平衡维持。此外,它还深入探讨了杯突症的内在机制及其与癌症信号通路之间的相互作用。报告还讨论了铜氧化酶和铁氧化酶之间的潜在协同作用及其对肿瘤免疫调节的影响。此外,解决癌症中的铜氧化酶增多问题的可行途径还包括评估铜螯合剂和离子载体的效用。这篇综述探讨了围绕铜氧化酶的迫切问题,概述了它在癌症发病和治疗中的关键作用,认为以铜氧化酶为靶点是抗肿瘤治疗的一个前景广阔的前沿领域,有可能彻底改变癌症治疗策略。
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引用次数: 0
Matrisomics: Beyond the extracellular matrix for unveiling tumor microenvironment Matrisomics:超越细胞外基质,揭示肿瘤微环境。
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-04 DOI: 10.1016/j.bbcan.2024.189178

The matrisome, a group of proteins constituting or interacting with the extracellular matrix (ECM), has garnered attention as a potent regulator of cancer progression. An increasing number of studies have focused on cancer matrisome utilizing diverse -omics approaches. Here, we present diverse patterns of matrisomal populations within cancer tissues, exploring recent -omics studies spanning different ‘-omics’ levels (epigenomics, genomics, transcriptomics, and proteomics), as well as newly developed sequencing techniques such as single-cell RNA sequencing and spatial transcriptomics. Some matrisome genes showed uniform patterns of upregulated or downregulated expression across various cancers, while others displayed different expression patterns according to the cancer types. This matrisomal dysregulation in cancer was further examined according to their originating cell type and spatial location in the tumor tissue. Experimental studies were also collected to demonstrate the identified roles of matrisome genes during cancer progression. Interestingly, many studies on cancer matrisome have suggested matrisome genes as effective biomarkers in cancer research. Although the specific mechanisms and clinical applications of cancer matrisome have not yet been fully elucidated, recent techniques and analyses on cancer matrisomics have emphasized their biological importance in cancer progression and their clinical implications in deciding the efficacy of cancer treatment.

基质组(matrisome)是一组构成细胞外基质(ECM)或与之相互作用的蛋白质,作为癌症进展的一个强有力的调控因子而备受关注。越来越多的研究利用不同的组学方法关注癌症基质组。在这里,我们介绍了癌症组织中基质组群体的不同模式,探讨了最近跨越不同 "组学 "水平(表观基因组学、基因组学、转录组学和蛋白质组学)的组学研究,以及新开发的测序技术,如单细胞 RNA 测序和空间转录组学。在各种癌症中,一些基质组基因表现出统一的上调或下调表达模式,而另一些基因则根据癌症类型表现出不同的表达模式。根据这些基因的起源细胞类型和在肿瘤组织中的空间位置,进一步研究了癌症中的基质组失调情况。此外,还收集了一些实验研究,以证明母体基因在癌症进展过程中的作用。有趣的是,许多关于癌症基质组的研究都认为基质组基因是癌症研究中有效的生物标志物。虽然癌症基质组的具体机制和临床应用尚未完全阐明,但最近的癌症基质组学技术和分析强调了它们在癌症进展中的生物学重要性,以及它们在决定癌症治疗效果方面的临床意义。
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引用次数: 0
Hydrogel encapsulation of mesenchymal stem cells-derived extracellular vesicles as a novel therapeutic approach in cancer therapy 水凝胶包裹间充质干细胞衍生的细胞外囊泡,作为癌症治疗的一种新疗法。
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-01 DOI: 10.1016/j.bbcan.2024.189177

Cell therapy has emerged as one of the most promising approaches to treating disease in recent decades. The application of stem cells in anti-tumor therapy is determined by their varying capacity for proliferation, migration, and differentiation. These capacities are derived from different sources. The use of stem cell carriers in cancer treatment is justified by the following three reasons: (I) shield therapeutic agents from swift biological deterioration; (II) reduce systemic side effects; and (III) increase local therapeutic levels since stem cells have an innate ability to target tumors. The quantity of stem cells confined to the tumor microenvironment determines this system's anti-tumor activity. Nevertheless, there are limitations to the use of different types of stem cells. When immune cells are used in cell therapy, it may lead to cytokine storms and improper reactions to self-antigens. Furthermore, the use of stem cells may result in cancer. Additionally, after an intravenous injection, cells could not migrate to the injury location. Exosomes derived from different cells were thus proposed as possible therapeutic options. Exosomes are becoming more and more well-liked because of their small size, biocompatibility, and simplicity in storage and separation. A number of investigations have shown that adding various medications and microRNAs to exosomes may enhance their therapeutic effectiveness. Thus, it is essential to evaluate studies looking into the therapeutic effectiveness of encapsulated exosomes. In this review, we looked at studies on encapsulated exosomes' use in regenerative medicine and the treatment of cancer. The results imply that the therapeutic potential increases when encapsulated exosomes are used rather than intact exosomes. Therefore, in order to optimize the effectiveness of the treatment, it is advised to implement this technique in accordance with the kind of therapy.

近几十年来,细胞疗法已成为治疗疾病最有前途的方法之一。干细胞的增殖、迁移和分化能力各不相同,这决定了干细胞在抗肿瘤疗法中的应用。这些能力来自不同的来源。在癌症治疗中使用干细胞载体有以下三个理由:(1)防止治疗药物迅速发生生物退化;(2)减少全身副作用;(3)提高局部治疗水平,因为干细胞天生具有靶向肿瘤的能力。局限在肿瘤微环境中的干细胞数量决定了这一系统的抗肿瘤活性。然而,使用不同类型的干细胞也有局限性。在细胞疗法中使用免疫细胞时,可能会导致细胞因子风暴和对自身抗原的不当反应。此外,使用干细胞还可能导致癌症。此外,静脉注射后,细胞无法迁移到受伤部位。因此,从不同细胞中提取的外泌体被认为是可能的治疗方案。由于外泌体体积小、生物相容性好、易于储存和分离,因此越来越受到人们的青睐。许多研究表明,在外泌体中添加各种药物和微RNA可提高其治疗效果。因此,有必要评估有关封装外泌体治疗效果的研究。在这篇综述中,我们考察了有关封装外泌体用于再生医学和癌症治疗的研究。研究结果表明,与完整的外泌体相比,封装外泌体的治疗潜力更大。因此,为了优化治疗效果,建议根据治疗类型来实施这项技术。
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引用次数: 0
Bioactive sphingolipids as emerging targets for signal transduction in cancer development 生物活性鞘脂是癌症发展过程中信号转导的新目标。
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-01 DOI: 10.1016/j.bbcan.2024.189176

Sphingolipids, crucial components of cellular membranes, play a vital role in maintaining cellular structure and signaling integrity. Disruptions in sphingolipid metabolism are increasingly implicated in cancer development. Key bioactive sphingolipids, such as ceramides, sphingosine-1-phosphate (S1P), ceramide-1-phosphate (C1P), and glycosphingolipids, profoundly impact tumor biology. They influence the behavior of tumor cells, stromal cells, and immune cells, affecting tumor aggressiveness, angiogenesis, immune modulation, and extracellular matrix remodeling. Furthermore, abnormal expression of sphingolipids and their metabolizing enzymes modulates the secretion of tumor-derived extracellular vesicles (TDEs), which are key players in creating an immunosuppressive tumor microenvironment, remodeling the extracellular matrix, and facilitating oncogenic signaling within in situ tumors and distant pre-metastatic niches (PMNs). Understanding the role of sphingolipids in the biogenesis of tumor-derived extracellular vesicles (TDEs) and their bioactive contents can pave the way for new biomarkers in cancer diagnosis and prognosis, ultimately enhancing comprehensive tumor treatment strategies.

鞘磷脂是细胞膜的重要组成部分,在维持细胞结构和信号完整性方面发挥着重要作用。鞘脂代谢紊乱与癌症发展的关系日益密切。关键的生物活性鞘脂,如神经酰胺、鞘氨醇-1-磷酸(S1P)、神经酰胺-1-磷酸(C1P)和糖鞘脂,会对肿瘤生物学产生深远影响。它们影响肿瘤细胞、基质细胞和免疫细胞的行为,影响肿瘤的侵袭性、血管生成、免疫调节和细胞外基质重塑。此外,鞘磷脂及其代谢酶的异常表达会调节肿瘤源性细胞外泡(TDEs)的分泌,而TDEs是创造免疫抑制性肿瘤微环境、重塑细胞外基质以及促进原位肿瘤和远处转移前壁龛(PMNs)内致癌信号传导的关键因素。了解鞘脂在肿瘤源性细胞外泡(TDEs)的生物生成过程中的作用及其生物活性成分,可以为癌症诊断和预后的新生物标记物铺平道路,最终提高肿瘤综合治疗策略的水平。
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引用次数: 0
Breaking through therapeutic barriers: Insights into CDK4/6 inhibition resistance in hormone receptor-positive metastatic breast cancer 突破治疗障碍:激素受体阳性转移性乳腺癌 CDK4/6 抑制剂耐药性透视。
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-01 DOI: 10.1016/j.bbcan.2024.189174

The therapeutic landscape for hormone receptor-positive (HR+) breast carcinoma has undergone a significant transformation with the advent of cyclin-dependent kinase (CDK)4/6 inhibitors, particularly in combination with endocrine therapy as the primary regimen. However, the evolution of resistance mechanisms in response to CDK4/6 inhibitors in HR+ metastatic breast cancer presents substantial challenges in managing the disease. This review explores the diverse genomic landscape underlying resistance, including disturbances in the cell cycle, deviations in oncogenic signaling pathways, deficiencies in DNA damage response (DDR) mechanisms, and changes in the tumor microenvironment (TME). Additionally, it discusses potential strategies to surmount resistance, including advancements in endocrine therapy, targeted inhibition of cell cycle components, suppression of AKT/mTOR activation, exploration of the FGFR pathway, utilization of antibody-drug conjugates (ADCs), and integration of immune checkpoint inhibitors (ICIs) with endocrine therapy and CDK4/6 inhibitors, providing pathways for enhancing patient outcomes amidst treatment challenges.

随着细胞周期蛋白依赖性激酶(CDK)4/6抑制剂的出现,尤其是与内分泌治疗联合作为主要治疗方案,激素受体阳性(HR+)乳腺癌的治疗格局发生了重大转变。然而,HR+转移性乳腺癌对CDK4/6抑制剂的耐药机制的演变给疾病的治疗带来了巨大挑战。本综述探讨了耐药性背后的各种基因组环境,包括细胞周期紊乱、致癌信号通路偏差、DNA损伤应答(DDR)机制缺陷以及肿瘤微环境(TME)变化。此外,它还讨论了克服耐药性的潜在策略,包括内分泌治疗的进展、细胞周期成分的靶向抑制、AKT/mTOR 激活的抑制、FGFR 通路的探索、抗体药物共轭物 (ADC) 的利用,以及免疫检查点抑制剂 (ICI) 与内分泌治疗和 CDK4/6 抑制剂的整合,为在治疗挑战中提高患者疗效提供了途径。
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引用次数: 0
ROS: A “booster” for chronic inflammation and tumor metastasis ROS:慢性炎症和肿瘤转移的 "助推器"。
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-31 DOI: 10.1016/j.bbcan.2024.189175

Reactive oxygen species (ROS) are a group of highly active molecules produced by normal cellular metabolism and play a crucial role in the human body. In recent years, researchers have increasingly discovered that ROS plays a vital role in the progression of chronic inflammation and tumor metastasis. The inflammatory tumor microenvironment established by chronic inflammation can induce ROS production through inflammatory cells. ROS can then directly damage DNA or indirectly activate cellular signaling pathways to promote tumor metastasis and development, including breast cancer, lung cancer, liver cancer, colorectal cancer, and so on. This review aims to elucidate the relationship between ROS, chronic inflammation, and tumor metastasis, explaining how chronic inflammation can induce tumor metastasis and how ROS can contribute to the evolution of chronic inflammation toward tumor metastasis. Interestingly, ROS can have a “double-edged sword” effect, promoting tumor metastasis in some cases and inhibiting it in others. This article also highlights the potential applications of ROS in inhibiting tumor metastasis and enhancing the precision of tumor-targeted therapy. Combining ROS with nanomaterials strategies may be a promising approach to enhance the efficacy of tumor treatment.

活性氧(ROS)是一组由正常细胞代谢产生的高活性分子,在人体内发挥着至关重要的作用。近年来,研究人员越来越多地发现,ROS 在慢性炎症进展和肿瘤转移中发挥着重要作用。慢性炎症所形成的炎症性肿瘤微环境可通过炎症细胞诱导 ROS 的产生。ROS 可直接损伤 DNA 或间接激活细胞信号通路,促进肿瘤的转移和发展,包括乳腺癌、肺癌、肝癌、结直肠癌等。本综述旨在阐明 ROS、慢性炎症和肿瘤转移之间的关系,解释慢性炎症如何诱导肿瘤转移,以及 ROS 如何促使慢性炎症向肿瘤转移演变。有趣的是,ROS 可以产生 "双刃剑 "效应,在某些情况下促进肿瘤转移,而在另一些情况下则抑制肿瘤转移。本文还强调了 ROS 在抑制肿瘤转移和提高肿瘤靶向治疗精确性方面的潜在应用。将 ROS 与纳米材料策略相结合可能是提高肿瘤治疗效果的一种有前途的方法。
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引用次数: 0
Insights into the role of connexins and specialized intercellular communication pathways in breast cancer: Mechanisms and applications 洞察附件蛋白和专门的细胞间通讯途径在乳腺癌中的作用:机制与应用
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-16 DOI: 10.1016/j.bbcan.2024.189173

Gap junctions, membrane-based channels comprised of connexin proteins (Cxs), facilitate direct communication among neighbouring cells and between cells and the extracellular space through their hemichannels. The normal human breast expresses various Cxs family proteins, such as Cx43, Cx30, Cx32, Cx46, and Cx26, crucial for proper tissue development and function. These proteins play a significant role in breast cancer development, progression, and therapy response. In primary tumours, there is often a reduction and cytoplasmic mislocalization of Cx43 and Cx26, while metastatic lesions show an upregulation of these and other Cxs. Although existing research predominantly supports the tumour-suppressing role of Cxs in primary carcinomas through channel-dependent and independent functions, controversies persist regarding their involvement in the metastatic process. This review aims to provide an updated perspective on Cxs in human breast cancer, with a specific focus on intrinsic subtypes due to the heterogeneous nature of this disease. Additionally, the manuscript will explore the role of Cxs in immune interactions and novel forms of intercellular communication, such as tunneling nanotubes and extracellular vesicles, within the breast tumour context and tumour microenvironment. Recent findings suggest that Cxs hold potential as therapeutic targets for mitigating metastasis and drug resistance. Furthermore, they may serve as novel biomarkers for cancer prognosis, offering promising avenues for future research and clinical applications.

间隙连接是由连接蛋白(Cxs)组成的膜基通道,通过其半通道促进相邻细胞之间以及细胞与细胞外空间之间的直接交流。正常人的乳房表达多种 Cxs 家族蛋白,如 Cx43、Cx30、Cx32、Cx46 和 Cx26,它们对组织的正常发育和功能至关重要。这些蛋白在乳腺癌的发生、发展和治疗反应中起着重要作用。在原发性肿瘤中,Cx43 和 Cx26 通常会减少并在细胞质中错误定位,而转移性病灶则显示出这些和其他 Cxs 的上调。尽管现有研究主要支持 Cxs 通过通道依赖性和独立功能在原发性癌症中发挥抑制肿瘤的作用,但关于它们在转移过程中的参与仍存在争议。本综述旨在提供有关人类乳腺癌中 Cxs 的最新观点,由于乳腺癌的异质性,本综述特别关注内在亚型。此外,文稿还将探讨 Cxs 在乳腺肿瘤和肿瘤微环境中的免疫相互作用和新型细胞间通信形式(如隧道纳米管和细胞外囊泡)中的作用。最新研究结果表明,Cxs 有可能成为减轻转移和耐药性的治疗靶点。此外,它们还可以作为癌症预后的新型生物标志物,为未来的研究和临床应用提供了广阔的前景。
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引用次数: 0
Modulating macrophage-mediated programmed cell removal: An attractive strategy for cancer therapy 调节巨噬细胞介导的程序性细胞清除:一种极具吸引力的癌症治疗策略
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-14 DOI: 10.1016/j.bbcan.2024.189172

Macrophage-mediated programmed cell removal (PrCR) is crucial for the identification and elimination of needless cells that maintain tissue homeostasis. The efficacy of PrCR depends on the balance between pro-phagocytic “eat me” signals and anti-phagocytic “don't eat me” signals. Recently, a growing number of studies have shown that tumourigenesis and progression are closely associated with PrCR. In the tumour microenvironment, PrCR activated by the “eat me” signal is counterbalanced by the “don't eat me” signal of CD47/SIRPα, resulting in tumour immune escape. Therefore, targeting exciting “eat me” signalling while simultaneously suppressing “don't eat me” signalling and eventually inducing macrophages to produce effective PrCR will be a very attractive antitumour strategy. Here, we comprehensively review the functions of PrCR-activating signal molecules (CRT, PS, Annexin1, SLAMF7) and PrCR-inhibiting signal molecules (CD47/SIRPα, MHC-I/LILRB1, CD24/Siglec-10, SLAMF3, SLAMF4, PD-1/PD-L1, CD31, GD2, VCAM1), the interactions between these molecules, and Warburg effect. In addition, we highlight the molecular regulatory mechanisms that affect immune system function by exciting or suppressing PrCR. Finally, we review the research advances in tumour therapy by activating PrCR and discuss the challenges and potential solutions to smooth the way for tumour treatment strategies that target PrCR.

巨噬细胞介导的程序性细胞清除(PrCR)对于识别和清除维持组织稳态的无用细胞至关重要。PrCR的功效取决于促吞噬细胞 "吃我 "信号和抗吞噬细胞 "别吃我 "信号之间的平衡。最近,越来越多的研究表明,肿瘤的发生和发展与 PrCR 密切相关。在肿瘤微环境中,由 "吃我 "信号激活的 PrCR 被 CD47/SIRPα 的 "不吃我 "信号抵消,导致肿瘤免疫逃逸。因此,在抑制 "不吃我 "信号的同时靶向刺激 "吃我 "信号,并最终诱导巨噬细胞产生有效的 PrCR,将是一种极具吸引力的抗肿瘤策略。在此,我们全面回顾了 PrCR 激活信号分子(CRT、PS、Annexin1、SLAMF7)和 PrCR 抑制信号分子(CD47/SIRPα、MHC-I/LILRB1、CD24/Siglec-10、SLAMF3、SLAMF4、PD-1/PD-L1、CD31、GD2、VCAM1)的功能、这些分子之间的相互作用以及沃伯格效应。此外,我们还强调了通过激发或抑制 PrCR 来影响免疫系统功能的分子调控机制。最后,我们回顾了通过激活 PrCR 治疗肿瘤的研究进展,并讨论了针对 PrCR 的肿瘤治疗策略所面临的挑战和潜在的解决方案。
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引用次数: 0
Unraveling molecular aberrations and pioneering therapeutic strategies in osteosarcoma 揭示骨肉瘤的分子畸变并开创治疗策略。
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-09 DOI: 10.1016/j.bbcan.2024.189171

Osteosarcoma, a rare primary bone cancer, presents diverse molecular aberrations that underscore its complexity. Despite the persistent endeavors by researchers, the limited amelioration in the five-year survival rate indicates that current therapeutic strategies prove inadequate in addressing the clinical necessities. Advancements in molecular profiling have facilitated an enhanced comprehension of the biology of osteosarcoma, offering a promising outlook for treatment. There is an urgent need to develop innovative approaches to address the complex challenges of osteosarcoma, ultimately contributing to enhanced patient outcomes. This review explores the nexus between osteosarcoma and cancer predisposition syndromes, intricacies in its somatic genome, and clinically actionable alterations. This review covers treatment strategies, including surgery, chemotherapy, immune checkpoint inhibitors (ICIs), and tyrosine kinase inhibitors (TKIs). Innovative treatment modalities targeting diverse pathways, including multi-target tyrosine kinases, cell cycle, PI3K/mTOR pathway, and DNA damage repair (DDR), offer promising interventions. This review also covers promising avenues, including antibody-drug conjugates (ADCs) and immunotherapy strategies, such as cytokines, adoptive cellular therapy (ACT), ICIs, and cancer vaccines. This comprehensive exploration contributes to a holistic understanding, offering guidance for clinical applications to advance the management of osteosarcoma.

骨肉瘤是一种罕见的原发性骨癌,其分子畸变多种多样,突显了其复杂性。尽管研究人员不懈努力,但五年生存率的改善有限,这表明目前的治疗策略不足以满足临床需要。分子图谱分析技术的进步促进了人们对骨肉瘤生物学特性的进一步了解,为治疗带来了美好的前景。目前迫切需要开发创新方法来应对骨肉瘤的复杂挑战,最终提高患者的治疗效果。本综述探讨了骨肉瘤与癌症易感综合征之间的关系、其体细胞基因组的复杂性以及临床上可操作的改变。本综述涵盖的治疗策略包括手术、化疗、免疫检查点抑制剂(ICIs)和酪氨酸激酶抑制剂(TKIs)。针对不同途径(包括多靶点酪氨酸激酶、细胞周期、PI3K/mTOR 途径和 DNA 损伤修复 (DDR))的创新治疗模式提供了前景广阔的干预措施。本综述还涵盖了前景广阔的途径,包括抗体药物共轭物(ADC)和免疫疗法策略,如细胞因子、采用性细胞疗法(ACT)、ICIs 和癌症疫苗。这一全面探讨有助于全面了解骨肉瘤,为临床应用提供指导,从而推进骨肉瘤的治疗。
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引用次数: 0
Small-molecule in cancer immunotherapy: Revolutionizing cancer treatment with transformative, game-changing breakthroughs 癌症免疫疗法中的小分子:以改变游戏规则的变革性突破彻底改变癌症治疗。
IF 9.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-09 DOI: 10.1016/j.bbcan.2024.189170

Immunotherapy has revolutionized cancer management, with antibody-based treatments leading the charge due to their superior pharmacodynamics, including enhanced effectiveness and specificity. However, these therapies are hampered by limitations such as prolonged half-lives, poor tissue and tumor penetration, and minimal oral bioavailability. Additionally, their immunogenic nature can cause adverse effects. Consequently, the focus is shifting towards small-molecule-based immunotherapies, which potentially overcome these drawbacks. Emerging as a promising alternative, small molecules offer the benefits of therapeutic antibodies and immunomodulators, often yielding synergistic effects when combined. Recent advancements in small-molecule cancer immunotherapy are notable, featuring inhibitors, agonists, and degraders that act as immunomodulators. This article delves into the current landscape of small-molecule immunotherapy in cancer treatment, highlighting novel agents targeting key pathways such as Toll-like receptors (TLR), PD-1/PD-L1, chemokine receptors, and stimulators of interferon genes (STING). The review emphasizes newly discovered molecular entities and their modulatory roles in tumorigenesis, many of which have progressed to clinical trials, that aims to provide a comprehensive snapshot of the evolving frontier in cancer treatment, driven by small-molecule immunomodulators.

免疫疗法为癌症治疗带来了革命性的变化,其中以抗体为基础的疗法因其卓越的药效学特性(包括更强的有效性和特异性)而独领风骚。然而,这些疗法也受到一些限制,如半衰期长、组织和肿瘤穿透性差、口服生物利用度低等。此外,它们的免疫原性也会导致不良反应。因此,目前的研究重点正转向小分子免疫疗法,这种疗法有可能克服这些缺点。小分子作为一种前景广阔的替代疗法,兼具治疗性抗体和免疫调节剂的优点,在联合使用时往往能产生协同效应。最近,小分子癌症免疫疗法取得了显著进展,其中包括作为免疫调节剂的抑制剂、激动剂和降解剂。本文深入探讨了当前小分子免疫疗法在癌症治疗中的应用,重点介绍了针对Toll样受体(TLR)、PD-1/PD-L1、趋化因子受体和干扰素基因刺激物(STING)等关键通路的新型药物。这篇综述强调了新发现的分子实体及其在肿瘤发生中的调节作用,其中许多已进入临床试验阶段,旨在全面概述小分子免疫调节剂推动的癌症治疗领域不断发展的前沿。
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