1.Immunometabolism: a new dimension in immunotherapy resistance.
Chaoyue XIAO ; Wei XIONG ; Yiting XU ; Ji'an ZOU ; Yue ZENG ; Junqi LIU ; Yurong PENG ; Chunhong HU ; Fang WU
Frontiers of Medicine 2023;17(4):585-616
Immune checkpoint inhibitors (ICIs) have demonstrated unparalleled clinical responses and revolutionized the paradigm of tumor treatment, while substantial patients remain unresponsive or develop resistance to ICIs as a single agent, which is traceable to cellular metabolic dysfunction. Although dysregulated metabolism has long been adjudged as a hallmark of tumor, it is now increasingly accepted that metabolic reprogramming is not exclusive to tumor cells but is also characteristic of immunocytes. Correspondingly, people used to pay more attention to the effect of tumor cell metabolism on immunocytes, but in practice immunocytes interact intimately with their own metabolic function in a way that has never been realized before during their activation and differentiation, which opens up a whole new frontier called immunometabolism. The metabolic intervention for tumor-infiltrating immunocytes could offer fresh opportunities to break the resistance and ameliorate existing ICI immunotherapy, whose crux might be to ascertain synergistic combinations of metabolic intervention with ICIs to reap synergic benefits and facilitate an adjusted anti-tumor immune response. Herein, we elaborate potential mechanisms underlying immunotherapy resistance from a novel dimension of metabolic reprogramming in diverse tumor-infiltrating immunocytes, and related metabolic intervention in the hope of offering a reference for targeting metabolic vulnerabilities to circumvent immunotherapeutic resistance.
Humans
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Neoplasms/pathology*
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Immunotherapy/methods*
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Immune Checkpoint Inhibitors/therapeutic use*
3.Liver-directed treatment is associated with improved survival and increased response to immune checkpoint blockade in metastatic uveal melanoma: results from a retrospective multicenter trial.
Elias A T KOCH ; Anne PETZOLD ; Anja WESSELY ; Edgar DIPPEL ; Markus ECKSTEIN ; Anja GESIERICH ; Ralf GUTZMER ; Jessica C HASSEL ; Harald KNORR ; Nicole KREUZBERG ; Ulrike LEITER ; Carmen LOQUAI ; Friedegund MEIER ; Markus MEISSNER ; Peter MOHR ; Claudia PFÖHLER ; Farnaz RAHIMI ; Dirk SCHADENDORF ; Max SCHLAAK ; Kai-Martin THOMS ; Selma UGUREL ; Jochen UTIKAL ; Michael WEICHENTHAL ; Beatrice SCHULER-THURNER ; Carola BERKING ; Markus V HEPPT
Frontiers of Medicine 2023;17(5):878-888
Metastases of uveal melanoma (UM) spread predominantly to the liver. Due to low response rates to systemic therapies, liver-directed therapies (LDT) are commonly used for tumor control. The impact of LDT on the response to systemic treatment is unknown. A total of 182 patients with metastatic UM treated with immune checkpoint blockade (ICB) were included in this analysis. Patients were recruited from prospective skin cancer centers and the German national skin cancer registry (ADOReg) of the German Dermatologic Cooperative Oncology Group (DeCOG). Two cohorts were compared: patients with LDT (cohort A, n = 78) versus those without LDT (cohort B, n = 104). Data were analyzed for response to treatment, progression-free survival (PFS), and overall survival (OS). The median OS was significantly longer in cohort A than in cohort B (20.1 vs. 13.8 months; P = 0.0016) and a trend towards improved PFS was observed for cohort A (3.0 vs. 2.5 months; P = 0.054). The objective response rate to any ICB (16.7% vs. 3.8%, P = 0.0073) and combined ICB (14.1% vs. 4.5%, P = 0.017) was more favorable in cohort A. Our data suggest that the combination of LDT with ICB may be associated with a survival benefit and higher treatment response to ICB in patients with metastatic UM.
Humans
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CTLA-4 Antigen
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Immune Checkpoint Inhibitors/therapeutic use*
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Liver
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Prospective Studies
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Skin Neoplasms
4.Analysis of interactions of immune checkpoint inhibitors with antibiotics in cancer therapy.
Yingying LI ; Shiyuan WANG ; Mengmeng LIN ; Chunying HOU ; Chunyu LI ; Guohui LI
Frontiers of Medicine 2022;16(3):307-321
The discovery of immune checkpoint inhibitors, such as PD-1/PD-L1 and CTLA-4, has played an important role in the development of cancer immunotherapy. However, immune-related adverse events often occur because of the enhanced immune response enabled by these agents. Antibiotics are widely applied in clinical treatment, and they are inevitably used in combination with immune checkpoint inhibitors. Clinical practice has revealed that antibiotics can weaken the therapeutic response to immune checkpoint inhibitors. Studies have shown that the gut microbiota is essential for the interaction between immune checkpoint inhibitors and antibiotics, although the exact mechanisms remain unclear. This review focuses on the interactions between immune checkpoint inhibitors and antibiotics, with an in-depth discussion about the mechanisms and therapeutic potential of modulating gut microbiota, as well as other new combination strategies.
Anti-Bacterial Agents/therapeutic use*
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Humans
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Immune Checkpoint Inhibitors/therapeutic use*
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Immunotherapy
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Neoplasms/drug therapy*
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Programmed Cell Death 1 Receptor
5.Cancer immunotherapy: an evolving paradigm.
Journal of Zhejiang University. Science. B 2022;23(10):791-792
The inhibition of the host's natural immune response by tumor cells was widely reported in the early phases of the development of oncology therapy, and the concept of employing the host's immune system to treat cancer, i.e. tumor immunotherapy, is not new. However, as a result of early theoretical constraints, clinical application of immunotherapy did not go smoothly and lagged significantly behind radiation and chemotherapy. The path has been winding, but the future now seems promising. Immunotherapy research has advanced enormously as a result of the maturing of immuno-editing theory and the creation of numerous technologies, despite a number of unsuccessful endeavors and clinical studies. Since around 1998, the US Food and Drug Administration (FDA) has approved a variety of tumor immunotherapies, including cytokines (interleukin-2, interferons), cancer vaccines (Provenge), immune checkpoint inhibitors (ipilimumab), and cellular therapies (chimeric antigen receptor-T (CAR-T)), signaling a boom in the field.
Cancer Vaccines/therapeutic use*
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Humans
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Immune Checkpoint Inhibitors
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Immunotherapy
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Interferons
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Interleukin-2/therapeutic use*
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Ipilimumab
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Neoplasms/pathology*
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Receptors, Chimeric Antigen
7.Advances in targeted and immune therapies for hepatocellular carcinoma.
Chinese Journal of Hepatology 2022;30(9):905-911
Targeted and immunotherapy drugs for hepatocellular carcinoma (HCC) have been rapidly developed. Atezolizumab in combination with bevacizumab has been recommended as the first-line standard of care for unresectable or advanced HCC in several national and international guidelines. The combination therapies with sindilizumab and bevacizumab biosimilar, apatinib and carrilizumab, dulvalizumab and tremelimumab are also recommended as first-line standard regimens for advanced HCC in the guideline of Chinese Society of Clinical Oncology. Local therapy combined with targeted drugs (such as sorafenib and lenvatinib) or immune checkpoint inhibitors can significantly improve outcomes. Therefore, some progress has also been made in the study of single-agent or combination regimens as perioperative neoadjuvant therapy.
Humans
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Carcinoma, Hepatocellular/pathology*
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Sorafenib/therapeutic use*
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Liver Neoplasms/pathology*
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Immune Checkpoint Inhibitors/therapeutic use*
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Bevacizumab/therapeutic use*
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Biosimilar Pharmaceuticals/therapeutic use*
8.PD-1 inhibitor plus anlotinib for metastatic castration-resistant prostate cancer: a real-world study.
Xin-Xing DU ; Yan-Hao DONG ; Han-Jing ZHU ; Xiao-Chen FEI ; Yi-Ming GONG ; Bin-Bin XIA ; Fan WU ; Jia-Yi WANG ; Jia-Zhou LIU ; Lian-Cheng FAN ; Yan-Qing WANG ; Liang DONG ; Yin-Jie ZHU ; Jia-Hua PAN ; Bai-Jun DONG ; Wei XUE
Asian Journal of Andrology 2023;25(2):179-183
Management and treatment of terminal metastatic castration-resistant prostate cancer (mCRPC) remains heavily debated. We sought to investigate the efficacy of programmed cell death 1 (PD-1) inhibitor plus anlotinib as a potential solution for terminal mCRPC and further evaluate the association of genomic characteristics with efficacy outcomes. We conducted a retrospective real-world study of 25 mCRPC patients who received PD-1 inhibitor plus anlotinib after the progression to standard treatments. The clinical information was extracted from the electronic medical records and 22 patients had targeted circulating tumor DNA (ctDNA) next-generation sequencing. Statistical analysis showed that 6 (24.0%) patients experienced prostate-specific antigen (PSA) response and 11 (44.0%) patients experienced PSA reduction. The relationship between ctDNA findings and outcomes was also analyzed. DNA-damage repair (DDR) pathways and homologous recombination repair (HRR) pathway defects indicated a comparatively longer PSA-progression-free survival (PSA-PFS; 2.5 months vs 1.2 months, P = 0.027; 3.3 months vs 1.2 months, P = 0.017; respectively). This study introduces the PD-1 inhibitor plus anlotinib as a late-line therapeutic strategy for terminal mCRPC. PD-1 inhibitor plus anlotinib may be a new treatment choice for terminal mCRPC patients with DDR or HRR pathway defects and requires further investigation.
Male
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Humans
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Prostate-Specific Antigen
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Treatment Outcome
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Prostatic Neoplasms, Castration-Resistant/drug therapy*
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Immune Checkpoint Inhibitors/therapeutic use*
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Retrospective Studies
9.Research Progress of Immune Checkpoint Inhibitor-associated Myocarditis.
Yunwei LIU ; Yanxin CHEN ; Zhimin ZENG ; Anwen LIU
Chinese Journal of Lung Cancer 2021;24(9):668-672
Immune checkpoint inhibitors (ICIs) is a negative regulatory factor antibody, which activates T cells to play an anti-tumor effect in immunotherapy, and can also cause immune-related adverse responses, thereby inducing a series of immune related adverse events (irAEs). Among these irAEs, although the incidence of ICIs-related myocarditis is very low, the fatality rate is significantly higher than other adverse reactions, close to 50%. Clinicians should be vigilant when applying ICIs, but the pathogenesis of ICIs-related myocarditis is still unclear. This article combines the recent research results of ICIs to summarize the mechanism and clinical manifestations of ICIs-related myocarditis, so as to improve clinicians' understanding of the adverse reactions.
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Biomedical Research/trends*
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Cardiotoxicity/physiopathology*
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Humans
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Immune Checkpoint Inhibitors/therapeutic use*
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Immunotherapy/adverse effects*
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Myocarditis/physiopathology*
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Neoplasms/drug therapy*
10.Immune checkpoint inhibitors in the treatment of colorectal cancer: a review of clinical trials.
Chinese Journal of Gastrointestinal Surgery 2022;25(3):205-213
Colorectal cancer is the third most common cancer in the world. The treatments include surgery, chemotherapy, radiotherapy and targeted therapy. The guidelines of many tumor types have been rewritten with the advent of immune checkpoint inhibitors. There are significant differences in the efficacy of immune checkpoint inhibitors in colorectal cancer according to microsatellite status. Microsatellite instability-high (MSI-H) colorectal cancer has made a breakthrough in immunotherapy, whether in the late-line, first-line, adjuvant or neoadjuvant therapy. The success of KEYNOTE-177 study has changed the guidelines with pembrolizumab becoming a standard treatment in the first-line treatment of MSI-H advanced colorectal cancer. The NICHE study, which used immunotherapy as neoadjuvant treatment of colorectal cancer, has made exciting achievements in MSI-H colorectal cancer. For microsatellite stability (MSS) colorectal cancer, many studies are ongoing, and immunotherapy is still unable to challenge the status of traditional treatment. In this paper, we review the clinical trials related to immune checkpoint inhibitors of colorectal cancer, expecting to provide references for the development of colorectal cancer immunotherapy.
Clinical Trials as Topic
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Colonic Neoplasms/drug therapy*
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Colorectal Neoplasms/pathology*
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Humans
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Immune Checkpoint Inhibitors/therapeutic use*
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Immunotherapy