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Electrical excitability of cancer cells-CELEX model updated. 癌细胞的电兴奋性--CELEX 模型更新。
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-08 DOI: 10.1007/s10555-024-10195-6
Mustafa B A Djamgoz

The normal functioning of every cell in the body depends on its bioelectric properties and many diseases are caused by genetic and/or epigenetic dysregulation of the underlying ion channels. Metastasis, the main cause of death from cancer, is a complex multi-stage process in which cells break away from a primary tumour, invade the surrounding tissues, enter the circulation by encountering a blood vessel and spread around the body, ultimately lodging in distant organs and reproliferating to form secondary tumours leading to devastating organ failure. Such cellular behaviours are well known to involve ion channels. The CELEX model offers a novel insight to metastasis where it is the electrical excitation of the cancer cells that is responsible for their aggressive and invasive behaviour. In turn, the hyperexcitability is underpinned by concomitant upregulation of functional voltage-gated sodium channels and downregulation of voltage-gated potassium channels. Here, we update the in vitro and in vivo evidence in favour of the CELEX model for carcinomas. The results are unequivocal for the sodium channel. The potassium channel arm is also broadly supported by existing evidence although these data are complicated by the impact of the channels on the membrane potential and consequent secondary effects. Finally, consistent with the CELEX model, we show (i) that carcinomas are indeed electrically excitable and capable of generating action potentials and (ii) that combination of a sodium channel inhibitor and a potassium channel opener can produce a strong, additive anti-invasive effect. We discuss the possible clinical implications of the CELEX model in managing cancer.

人体内每个细胞的正常功能都取决于其生物电特性,许多疾病都是由潜在离子通道的遗传和/或表观遗传失调引起的。转移是癌症导致死亡的主要原因,它是一个复杂的多阶段过程,在这个过程中,细胞脱离原发肿瘤,侵入周围组织,遇到血管进入血液循环,并在身体各处扩散,最终在远处器官停留并重新增殖,形成继发性肿瘤,导致毁灭性的器官衰竭。众所周知,这种细胞行为涉及离子通道。CELEX 模型为癌细胞转移提供了一个新的视角,即癌细胞的电兴奋是其侵袭和入侵行为的罪魁祸首。反过来,电压门控钠离子通道的功能上调和电压门控钾离子通道的功能下调又是高兴奋性的基础。在此,我们更新了支持 CELEX 癌症模型的体外和体内证据。钠通道的结果是明确的。钾通道部分也得到了现有证据的广泛支持,尽管这些数据由于通道对膜电位的影响以及随之而来的次生效应而变得复杂。最后,与 CELEX 模型一致,我们证明:(i) 癌症确实具有电兴奋性,能够产生动作电位;(ii) 结合使用钠通道抑制剂和钾通道开放剂可以产生强大的叠加抗侵袭效应。我们讨论了 CELEX 模型在治疗癌症方面可能具有的临床意义。
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引用次数: 0
Peptides for microbe-induced cancers: latest therapeutic strategies and their advanced technologies. 肽治疗微生物诱发的癌症:最新治疗策略及其先进技术。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI: 10.1007/s10555-024-10197-4
Ziqi Lin, Yehuda G Assaraf, Hang Fai Kwok

Cancer is a significant global health concern associated with multiple distinct factors, including microbial and viral infections. Numerous studies have elucidated the role of microorganisms, such as Helicobacter pylori (H. pylori), as well as viruses for example human papillomavirus (HPV), hepatitis B virus (HBV), and hepatitis C virus (HCV), in the development of human malignancies. Substantial attention has been focused on the treatment of these microorganism- and virus-associated cancers, with promising outcomes observed in studies employing peptide-based therapies. The current paper provides an overview of microbe- and virus-induced cancers and their underlying molecular mechanisms. We discuss an assortment of peptide-based therapies which are currently being developed, including tumor-targeting peptides and microbial/viral peptide-based vaccines. We describe the major technological advancements that have been made in the design, screening, and delivery of peptides as anticancer agents. The primary focus of the current review is to provide insight into the latest research and development in this field and to provide a realistic glimpse into the future of peptide-based therapies for microbe- and virus-induced neoplasms.

癌症是全球关注的重大健康问题,与多种不同因素有关,包括微生物和病毒感染。大量研究阐明了幽门螺杆菌等微生物以及人乳头状瘤病毒(HPV)、乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)等病毒在人类恶性肿瘤发病中的作用。治疗这些与微生物和病毒相关的癌症已成为人们关注的焦点,采用多肽疗法的研究也取得了可喜的成果。本文概述了微生物和病毒诱发的癌症及其潜在的分子机制。我们讨论了目前正在开发的各种基于肽的疗法,包括肿瘤靶向肽和基于微生物/病毒肽的疫苗。我们介绍了在多肽抗癌剂的设计、筛选和递送方面取得的主要技术进展。本综述的主要重点是深入探讨这一领域的最新研究与发展,并对基于多肽的微生物和病毒诱发肿瘤疗法的未来提供现实的一瞥。
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引用次数: 0
CAR T cells in solid tumors and metastasis: paving the way forward. CAR T 细胞在实体瘤和转移中的应用:铺平道路。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI: 10.1007/s10555-024-10213-7
Camilla Sirini, Laura De Rossi, Marta Angiola Moresco, Monica Casucci

CAR T cell therapy, hailed as a breakthrough in cancer treatment due to its remarkable outcomes in hematological malignancies, encounters significant hurdles when applied to solid tumors. While notable responses to CAR T cells remain sporadic in these patients, challenges persist due to issues such as on-target off-tumor toxicity, difficulties in their trafficking and infiltration into the tumor, and the presence of a hostile and immunosuppressive microenvironment. This review aims to explore recent endeavors aimed at overcoming these obstacles in CAR T cell therapy for solid tumors. Specifically, we will delve into promising strategies for enhancing tumor specificity through antigen targeting, addressing tumor heterogeneity, overcoming physical barriers, and counteracting the immune-suppressive microenvironment.

CAR T 细胞疗法因其在血液恶性肿瘤中的显著疗效而被誉为癌症治疗领域的一大突破,但在应用于实体瘤时却遇到了重大障碍。虽然这些患者对 CAR T 细胞的显著反应仍是零星的,但由于靶向肿瘤外毒性、肿瘤内运输和浸润困难以及存在敌意和免疫抑制性微环境等问题,挑战依然存在。本综述旨在探讨最近旨在克服 CAR T 细胞治疗实体瘤的这些障碍的努力。具体来说,我们将深入探讨通过抗原靶向增强肿瘤特异性、解决肿瘤异质性、克服物理障碍以及对抗免疫抑制性微环境的可行策略。
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引用次数: 0
CAR T-cell therapy for B-cell lymphomas: outcomes and resistance mechanisms. CAR - t细胞治疗b细胞淋巴瘤:结果和耐药机制。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 DOI: 10.1007/s10555-024-10228-0
Tyce J Kearl, Fateeha Furqan, Nirav N Shah

Chimeric antigen receptor (CAR) T cells are an exciting curative intent approach to the treatment of non-Hodgkin lymphomas (NHLs). Several products have received FDA approval for 2nd or 3rd line indications, and studies are underway for their use earlier in the disease course. These CAR T cells are ex vivo manufactured autologous cell products that specifically target tumor antigens to optimize tumor specificity and minimize off-tumor side effects-in NHLs, this is typically achieved by targeting B-cell antigens. Engagement of the CAR and corresponding antigen is designed to result in T-cell activation and subsequent tumor clearance. While curative for many NHL patients, too many patients fail to respond to or relapse following CAR T-cell treatment, and salvage options post CAR T-cell therapy are limited. Treatment failures occur because of myriad resistance mechanisms including CAR T-cell dysfunction, generalized immune dysregulation, and intrinsic tumor resistance. Focusing on patients with NHL, we review the clinical outcomes of CAR T-cell therapy and the major resistance mechanisms that lead to poor outcomes. We also review the many innovative and encouraging strategies that are being developed to improve CAR T-cell therapy for NHL.

嵌合抗原受体(CAR) T细胞是治疗非霍奇金淋巴瘤(nhl)的一种令人兴奋的治疗意图方法。一些产品已获得FDA批准用于二线或三线适应症,并且正在进行研究,以便在疾病过程的早期使用。这些CAR - T细胞是体外制造的自体细胞产物,特异性靶向肿瘤抗原,以优化肿瘤特异性并最大限度地减少肿瘤外副作用——在nhl中,这通常是通过靶向b细胞抗原来实现的。CAR和相应抗原的结合被设计成t细胞活化和随后的肿瘤清除。虽然对许多NHL患者有疗效,但太多患者在CAR - t细胞治疗后没有反应或复发,并且CAR - t细胞治疗后的挽救选择有限。治疗失败的原因是无数的耐药机制,包括CAR - t细胞功能障碍、全身免疫失调和内在的肿瘤耐药。针对NHL患者,我们回顾了CAR - t细胞治疗的临床结果以及导致不良结果的主要耐药机制。我们还回顾了许多正在开发的创新和令人鼓舞的策略,以改善NHL的CAR - t细胞治疗。
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引用次数: 0
Multiomics approach towards characterization of tumor cell plasticity and its significance in precision and personalized medicine. 多组学方法表征肿瘤细胞的可塑性及其在精准和个性化医疗中的意义。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-05-18 DOI: 10.1007/s10555-024-10190-x
Mohammad Azhar Aziz

Cellular plasticity refers to the ability of cells to change their identity or behavior, which can be advantageous in some cases (e.g., tissue regeneration) but detrimental in others (e.g., cancer metastasis). With a better understanding of cellular plasticity, the complexity of cancer cells, their heterogeneity, and their role in metastasis is being unraveled. The plasticity of the cells could also prove as a nemesis to their characterization. In this review, we have attempted to highlight the possibilities and benefits of using multiomics approach in characterizing the plastic nature of cancer cells. There is a need to integrate fragmented evidence at different levels of cellular organization (DNA, RNA, protein, metabolite, epigenetics, etc.) to facilitate the characterization of different forms of plasticity and cell types. We have discussed the role of cellular plasticity in generating intra-tumor heterogeneity. Different omics level evidence is being provided to highlight the variety of molecular determinants discovered using different techniques. Attempts have been made to integrate some of this information to provide a quantitative assessment and scoring of the plastic nature of the cells. However, there is a huge gap in our understanding of mechanisms that lead to the observed heterogeneity. Understanding of these mechanism(s) is necessary for finding targets for early detection and effective therapeutic interventions in metastasis. Targeting cellular plasticity is akin to neutralizing a moving target. Along with the advancements in precision and personalized medicine, these efforts may translate into better clinical outcomes for cancer patients, especially in metastatic stages.

细胞可塑性是指细胞改变自身特性或行为的能力,在某些情况下这种能力是有利的(如组织再生),但在另一些情况下则是有害的(如癌症转移)。随着对细胞可塑性的深入了解,癌细胞的复杂性、异质性及其在转移中的作用也逐渐被揭开。细胞的可塑性也可能成为表征它们的克星。在这篇综述中,我们试图强调使用多组学方法表征癌细胞可塑性的可能性和益处。有必要整合细胞组织不同层次(DNA、RNA、蛋白质、代谢物、表观遗传学等)的零散证据,以促进对不同形式的可塑性和细胞类型进行表征。我们讨论了细胞可塑性在产生肿瘤内异质性方面的作用。我们提供了不同的 omics 级证据,以突出利用不同技术发现的各种分子决定因素。人们试图整合其中一些信息,对细胞的可塑性进行量化评估和评分。然而,我们对导致所观察到的异质性的机制的理解还存在巨大差距。要找到早期检测和有效治疗转移的靶点,就必须了解这些机制。针对细胞的可塑性就好比中和一个移动的目标。随着精准医学和个性化医学的发展,这些努力可能会为癌症患者带来更好的临床疗效,尤其是在转移阶段。
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引用次数: 0
Correlates of health-related quality of life in African Americans diagnosed with cancer: a review of survivorship studies and the Detroit research on cancer survivors cohort. 被诊断患有癌症的非裔美国人健康相关生活质量的相关因素:幸存者研究和底特律癌症幸存者队列研究综述。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-20 DOI: 10.1007/s10555-024-10200-y
Matthew R Trendowski, Julie J Ruterbusch, Tara E Baird, Angela S Wenzlaff, Stephanie S Pandolfi, Theresa A Hastert, Ann G Schwartz, Jennifer L Beebe-Dimmer

Advances in cancer screening and treatment have improved survival after a diagnosis of cancer. As the number of cancer survivors as well as their overall life-expectancy increases, investigations of health-related quality of life (HRQOL) are critical in understanding the factors that promote the optimal experience over the course of survivorship. However, there is a dearth of information on determinants of HRQOL for African American cancer survivors as the vast majority of cohorts have been conducted predominantly among non-Hispanic Whites. In this review, we provide a review of the literature related to HRQOL in cancer survivors including those in African Americans. We then present a summary of published work from the Detroit Research on Cancer Survivors (ROCS) cohort, a population-based cohort of more than 5000 African American cancer survivors. Overall, Detroit ROCS has markedly advanced our understanding of the unique factors contributing to poorer HRQOL among African Americans with cancer. This work and future studies will help inform potential interventions to improve the long-term health of this patient population.

癌症筛查和治疗的进步提高了癌症确诊后的生存率。随着癌症幸存者人数的增加及其整体预期寿命的延长,对健康相关生活质量(HRQOL)的调查对于了解促进幸存者在整个生存过程中获得最佳体验的因素至关重要。然而,有关非裔美国人癌症幸存者的 HRQOL 决定因素的信息却非常匮乏,因为绝大多数的队列研究主要是针对非西班牙裔白人进行的。在本综述中,我们回顾了与癌症幸存者(包括非裔美国人)的 HRQOL 相关的文献。然后,我们总结了底特律癌症幸存者研究(ROCS)队列发表的研究成果,该队列是由 5000 多名非裔美国人癌症幸存者组成的人群队列。总体而言,底特律癌症幸存者研究极大地促进了我们对导致非裔美国人癌症患者 HRQOL 较差的独特因素的了解。这项工作和未来的研究将有助于为潜在的干预措施提供信息,从而改善这一患者群体的长期健康状况。
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引用次数: 0
Cancer treatments as paradoxical catalysts of tumor awakening in the lung. 癌症治疗是肺部肿瘤苏醒的矛盾催化剂。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-04 DOI: 10.1007/s10555-024-10196-5
Emmanuelle Nicolas, Beata Kosmider, Edna Cukierman, Hossein Borghaei, Erica A Golemis, Lucia Borriello

Much of the fatality of tumors is linked to the growth of metastases, which can emerge months to years after apparently successful treatment of primary tumors. Metastases arise from disseminated tumor cells (DTCs), which disperse through the body in a dormant state to seed distant sites. While some DTCs lodge in pre-metastatic niches (PMNs) and rapidly develop into metastases, other DTCs settle in distinct microenvironments that maintain them in a dormant state. Subsequent awakening, induced by changes in the microenvironment of the DTC, causes outgrowth of metastases. Hence, there has been extensive investigation of the factors causing survival and subsequent awakening of DTCs, with the goal of disrupting these processes to decrease cancer lethality. We here provide a detailed overview of recent developments in understanding of the factors controlling dormancy and awakening in the lung, a common site of metastasis for many solid tumors. These factors include dynamic interactions between DTCs and diverse epithelial, mesenchymal, and immune cell populations resident in the lung. Paradoxically, among key triggers for metastatic outgrowth, lung tissue remodeling arising from damage induced by the treatment of primary tumors play a significant role. In addition, growing evidence emphasizes roles for inflammation and aging in opposing the factors that maintain dormancy. Finally, we discuss strategies being developed or employed to reduce the risk of metastatic recurrence.

肿瘤的致命性在很大程度上与转移瘤的生长有关,转移瘤可能在原发性肿瘤治疗明显成功后数月至数年才出现。转移瘤源于扩散的肿瘤细胞(DTCs),它们以休眠状态在体内扩散,在远处播下种子。有些 DTC 在转移前壁龛(PMN)中停留并迅速发展为转移瘤,而其他 DTC 则在不同的微环境中定居,使其处于休眠状态。随后,在 DTC 微环境变化的诱导下,DTC 被唤醒,导致转移瘤的生长。因此,人们对导致 DTCs 存活和随后苏醒的因素进行了广泛的研究,目的是破坏这些过程以降低癌症的致死率。肺部是许多实体瘤的常见转移部位,我们在此详细综述了对肺部休眠和唤醒控制因素的最新认识进展。这些因素包括 DTC 与常驻肺部的各种上皮细胞、间充质细胞和免疫细胞群之间的动态相互作用。矛盾的是,在转移瘤生长的关键诱因中,原发性肿瘤治疗引起的损伤所导致的肺组织重塑起着重要作用。此外,越来越多的证据强调了炎症和衰老在对抗维持休眠的因素方面的作用。最后,我们将讨论正在开发或采用的降低转移复发风险的策略。
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引用次数: 0
Striated muscle: an inadequate soil for cancers. 横纹肌:癌症的土壤不足。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-12 DOI: 10.1007/s10555-024-10199-2
Alastair A E Saunders, Rachel E Thomson, Craig A Goodman, Robin L Anderson, Paul Gregorevic

Many organs of the body are susceptible to cancer development. However, striated muscles-which include skeletal and cardiac muscles-are rarely the sites of primary cancers. Most deaths from cancer arise due to complications associated with the development of secondary metastatic tumours, for which there are few effective therapies. However, as with primary cancers, the establishment of metastatic tumours in striated muscle accounts for a disproportionately small fraction of secondary tumours, relative to the proportion of body composition. Examining why primary and metastatic cancers are comparatively rare in striated muscle presents an opportunity to better understand mechanisms that can influence cancer cell biology. To gain insights into the incidence and distribution of muscle metastases, this review presents a definitive summary of the 210 case studies of metastasis in muscle published since 2010. To examine why metastases rarely form in muscles, this review considers the mechanisms currently proposed to render muscle an inhospitable environment for cancers. The "seed and soil" hypothesis proposes that tissues' differences in susceptibility to metastatic colonization are due to differing host microenvironments that promote or suppress metastatic growth to varying degrees. As such, the "soil" within muscle may not be conducive to cancer growth. Gaining a greater understanding of the mechanisms that underpin the resistance of muscles to cancer may provide new insights into mechanisms of tumour growth and progression, and offer opportunities to leverage insights into the development of interventions with the potential to inhibit metastasis in susceptible tissues.

人体的许多器官都容易罹患癌症。然而,横纹肌(包括骨骼肌和心肌)很少是原发性癌症的发病部位。大多数癌症患者的死亡都是由于继发性转移瘤引起的并发症造成的,而目前几乎没有有效的治疗方法。然而,与原发性癌症一样,在横纹肌中形成的转移性肿瘤在继发性肿瘤中所占的比例,相对于身体组成的比例而言,小得不成比例。研究横纹肌中原发性和转移性癌症相对罕见的原因,为更好地了解影响癌细胞生物学的机制提供了机会。为了深入了解肌肉转移的发生率和分布情况,本综述对 2010 年以来发表的 210 个肌肉转移病例研究进行了权威总结。为了探究肌肉中很少出现转移的原因,本综述考虑了目前提出的使肌肉成为癌症不适宜生长环境的机制。种子和土壤 "假说认为,组织对转移定植的易感性差异是由于不同的宿主微环境在不同程度上促进或抑制了转移的生长。因此,肌肉内的 "土壤 "可能不利于癌症生长。进一步了解肌肉抵抗癌症的机制,可能会对肿瘤生长和进展的机制有新的认识,并为开发有可能抑制易感组织转移的干预措施提供机会。
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引用次数: 0
The roles of periostin derived from cancer-associated fibroblasts in tumor progression and treatment response. 来源于癌症相关成纤维细胞的骨膜蛋白在肿瘤进展和治疗反应中的作用。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-11-30 DOI: 10.1007/s10555-024-10233-3
Yasmin De Oliveira Macena, Maria Eduarda Nunes Cezar, Cinthya Brunelly Ferreira Lira, Laryssa Bheatriz Dantas Machado De Oliveira, Thais Noronha Almeida, Ana Dora Alecio Virtuoso Costa, Bernardo Mansur Dantas De Araujo, Durval de Almeida Junior, Henrique Macêdo Dantas, Emanuel Cézar De Mélo, Sandra Taveiros de Araújo, Raimundo Rodrigues de França Júnior, Maria Amélia Dos Santos Lemos Gurgel, Carlos Alberto de Carvalho Fraga

Periostin (POSTN), a matricellular protein predominantly secreted by cancer-associated fibroblasts (CAFs), has emerged as a key regulator of cancer progression and therapy response. This review provides an overview of recent findings regarding the diverse roles of periostin in cancer therapy and its potential as a therapeutic target. Studies have elucidated periostin's involvement in tumorigenesis, including tumor growth, metastasis, chemotherapy resistance, and modulation of the tumor microenvironment (TME). CAFs periostin + play a central role in shaping the TME by remodeling the extracellular matrix (ECM) and promoting immune evasion, thus promoting tumor cell survival and dissemination. Elevated periostin expression has been correlated with poor prognosis across multiple cancer types, suggesting its utility as a prognostic biomarker. Periostin has been implicated in mediating resistance to chemotherapy, with CAFs periostin + establishing a pro-tumorigenic niche that confers protection to cancer cells against cytotoxic therapies. Targeting periostin or its downstream effectors presents a promising strategy to overcome therapy resistance and enhance treatment efficacy. While significant progress has been made in understanding the biological functions of periostin in cancer, gaps persist in elucidating its precise mechanisms of action and clinical relevance. Future research should focus on deciphering the signaling pathways and molecular interactions underlying periostin-mediated effects in the TME. Prospective clinical studies are warranted to evaluate periostin as a predictive biomarker and therapeutic target in cancer patients.

骨膜蛋白(POSTN)是一种主要由癌症相关成纤维细胞(CAFs)分泌的基质细胞蛋白,已成为癌症进展和治疗反应的关键调节因子。本文综述了近期关于骨膜蛋白在癌症治疗中的不同作用及其作为治疗靶点的潜力的研究结果。研究已经阐明了骨膜蛋白参与肿瘤发生,包括肿瘤生长、转移、化疗耐药和肿瘤微环境(TME)的调节。CAFs的periostin +通过重塑细胞外基质(extracellular matrix, ECM)和促进免疫逃逸,从而促进肿瘤细胞的存活和传播,在TME的形成中发挥核心作用。在多种癌症类型中,高表达的骨膜蛋白与预后不良相关,提示其作为预后生物标志物的效用。骨膜蛋白与化疗耐药的介导有关,CAFs骨膜蛋白+建立了一个促肿瘤的生态位,保护癌细胞免受细胞毒性疗法的侵害。以骨膜蛋白或其下游效应物为靶点,是克服治疗耐药、提高治疗疗效的有效途径。虽然在了解骨膜蛋白在癌症中的生物学功能方面取得了重大进展,但在阐明其确切的作用机制和临床相关性方面仍然存在差距。未来的研究应侧重于破译骨膜蛋白介导的TME效应的信号通路和分子相互作用。有必要进行前瞻性临床研究,以评估骨膜蛋白作为癌症患者的预测性生物标志物和治疗靶点。
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引用次数: 0
Immunotherapy for leptomeningeal disease from solid tumors: current clinical outcomes and future opportunities. 实体瘤引起的脑膜轻脑病的免疫治疗:目前的临床结果和未来的机会。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-11-29 DOI: 10.1007/s10555-024-10235-1
Eleanor C Smith, Bryan T Mott, Emily Douglas, Stephen B Tatter, Kounosuke Watabe

Leptomeningeal disease is a debilitating, late-stage form of metastatic cancer disseminated within the cerebrospinal fluid, subarachnoid space, and leptomeninges, leading to significant neurological morbidity and mortality. As systemic cancer treatments improve, rates of leptomeningeal disease have increased, yet prognosis remains exceedingly poor. A wide range of treatment modalities have been trialed; however, no standard of care has been established. Additionally, many clinical trials exclude patients with leptomeningeal disease, limiting available prospective data. In this review, we discuss the efficacy of immunotherapy for leptomeningeal disease from solid tumors including systemic and intrathecal therapies, as well as combined therapy regimens. Our review indicates a continued deficiency in the current prospective literature and highlights ongoing research regarding the leptomeningeal immune microenvironment, which will be critical in directing future study of leptomeningeal disease treatment. Currently, the efficacy of immunotherapies on leptomeningeal disease appears limited, and further prospective research is needed to draw significant conclusions. However, recent advancement in understanding the leptomeningeal microenvironment points to potential efficacy of novel immunotherapies targeting the innate immune system, and further study is warranted to evaluate the efficacy of these treatments in this subpopulation of patients.

轻脑膜病是一种使人衰弱的晚期转移性癌症,播散在脑脊液、蛛网膜下腔和轻脑膜内,可导致严重的神经系统发病率和死亡率。随着全身性癌症治疗的改善,脑膜轻脑病的发病率增加,但预后仍然非常差。已经试验了各种各样的治疗方式;然而,没有建立护理标准。此外,许多临床试验排除了轻脑膜疾病患者,限制了现有的前瞻性数据。在这篇综述中,我们讨论了免疫治疗对实体肿瘤引起的脑脊膜病的疗效,包括全身和鞘内治疗,以及联合治疗方案。我们的综述指出了目前前瞻性文献的持续不足,并强调了正在进行的关于薄脑膜免疫微环境的研究,这将对指导未来薄脑膜疾病治疗的研究至关重要。目前,免疫治疗对脑脊膜病的疗效有限,需要进一步的前瞻性研究来得出有意义的结论。然而,最近在了解轻脑膜微环境方面的进展指出了针对先天免疫系统的新型免疫疗法的潜在疗效,需要进一步的研究来评估这些治疗在这一亚群患者中的疗效。
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引用次数: 0
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Cancer and Metastasis Reviews
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