溶瘤病毒市场及研发格局分析

溶瘤病毒可以感染和破坏癌组织,是一种治疗癌症的新型生物疗法。溶瘤病毒在癌细胞中选择性复制,进而导致癌细胞裂解,释放肿瘤特异性抗原,诱导抗癌免疫反应,充当原位肿瘤疫苗。对病毒进入、复制、诱导和抑制免疫反应机制的深入了解促进了利用病毒治疗人类疾病技术的发展。过去十年溶瘤病毒领域临床试验的进展证实了其对癌症患者的治疗益处,利用溶瘤病毒作为载体治疗特定类型的癌症是肿瘤免疫治疗市场的新增长点。通过全面分析溶瘤病毒免疫治疗市场的细分领域及其市场动态,从关键技术进展、主要企业竞争格局和产品研发进展角度进行分析,并展望溶瘤病毒的发展前景,旨在为相关企业研发方向选择及地区产业决策提供参考。     

全球肿瘤免疫治疗药物研发态势

正肿瘤免疫治疗被称为继手术、化疗、放疗后第4种疗法,其可激活特异性的免疫细胞,直接靶向性攻击癌症细胞,具有较高的疗效和安全性,是目前全球肿瘤治疗研究的热点。截至2016年4月15日,全球各医药企业和研究机构已针对CTLA-4、PD-1、PD-L1三个靶标进行了近115种肿瘤免疫治疗的生物技术药物的研发,文章就其中肿瘤免疫治疗药物的主要靶标、开发企业及市场前景等进行了分析。     

不断扩大的癌症免疫治疗法市场

2009年以来，接受癌症免疫疗法治疗的患者呈现增长势态。 随着癌症免疫研究的进展和病例的积累，医生和患者都改变了认识。出现了大医院等大规模医疗机构也积极地开展免疫治疗的局面。     

基于铁死亡的抗结直肠癌药物的应用

结直肠癌（colorectal cancer，CRC）是癌症相关死亡的第二大主要原因，且患者趋于年轻化，化疗、免疫治疗及靶向治疗等药物治疗虽然取得进展，但因药物的毒性、耐药及价格昂贵严重影响CRC的综合治疗效果，因此寻求新的、更敏感有效的药物和药物靶点是目前研究的热点。铁死亡作为一种近期发现的细胞死亡调节方式，它与癌症药物耐药性、敏感性密切相关，激活铁死亡成为克服传统癌症治疗耐药机制的潜在策略，诱导铁死亡的药物研发应用有望成为治疗CRC的有效手段。本文综述在CRC中铁死亡相关代谢途径药物研究的最新进展，以便整体认识基于铁死亡的药物在CRC中作用的具体机制，充分发掘其治疗潜力，为CRC的诊疗和耐药性的解决提供新的思路。     

病毒介导的免疫治疗癌症进展探究

癌症作为近些年来威胁人类健康的疾病,现代医学研究上引起人们的关注,近几年病毒介导在有关癌症的免疫治疗方面发挥着不可忽视的成效。笔者通过对以几个方面病毒介导免疫治疗的讨论,如病毒介导载体类型,对癌细胞的调节,以及对宿主细胞的调节,阐明了病毒介导对癌细胞发展的机制,对病毒介导的癌症治疗和临床研究提供了研究的方向。     

Nature:肿瘤特异性抗原表位检测,推动个体化肿瘤免疫治疗

<正>近日,来自德国的科学家在国际学术期刊nature发表文章,提出了一种靶向癌症病人全谱肿瘤特异性突变的个体化肿瘤免疫治疗方案。肿瘤特异性突变是癌症免疫治疗的理想靶向目标,因为它们在健康组织中不表达,因此能够作为新抗原被成熟T细胞所识别。但根据肿瘤特异性突变开发疫苗进行系统性癌症免疫治疗仍存在很大障碍,每个癌症病人都有其独特的肿瘤特异性突变存在,因此要先对其肿瘤特异性突变     

免疫检查点阻断剂促进T细胞应答的影响因素

抑制免疫调节检查点,比如PD-1/PD-L1与CTLA-4,是癌症免疫治疗的前沿科学。然而这样的免疫疗法只对少部分患者的癌症形成有效。本文通过分析肿瘤的成瘤原因、微环境及其自体相关因素后发现这些因素均会导致免疫检查点阻断剂在体内失去T细胞免疫应答。因此,本文描述了免疫系统与宿主肠道微生物群可调控癌症免疫治疗的应答,并且在使用免疫检查点阻断剂的同时或之前调节肠道微生物群可以优化治疗效果。     

TAEST16001:TCR亲和力增强型特异性T细胞免疫治疗

人体的免疫系统, 相比于二十年前,通过近几十年的研究积累已经被比较清晰地诠释。特别是其在肿瘤的发生发展中的作用已引起前所未有的重视。人们发现利用免疫系统的相关分子可以非常有效地控制癌症,甚至可以完全治愈癌症。在一开始,这种现象仅是比较零星地在专业圈子里流传,但自从癌症的免疫治疗于2013年被Science杂志评为年度十大科技突破之首后,免疫治疗的成果便不断刷屏普通人的信息网络。这一现象的高潮表现在2018年诺奖评委再也按耐不住原本谨慎的态度,终于将医学与生理学奖颁发给了两位免疫学家,以表彰他们分别发现两个重要的免疫调控分子PD-1和CTLA-4的作用。因为靶向这两个分子的抗体在肿瘤的免疫治疗中表现出可预测的效果。更进一步的肯定是将同年的诺贝尔化学奖的一半授予了产生抗体的噬菌体展示技术的发明者。因此免疫治疗成为肿瘤治疗的重要手段,被列为继手术、放疗、化疗之后的第四种模式,就变成不争的事实了。肿瘤免疫治疗可以通过单一分子药物来实现,也可以通过含有成千上万分子的免疫细胞来完成。而后者则是借助细胞工程技术,修饰相关的免疫细胞,在体外扩增后回输给相应的患者,以增强和激发机体的抗肿瘤免疫能力,并最终达到清除体内肿瘤细胞的目的。对T细胞免疫治疗的相关原理及目前应用发展情况进行了简单的介绍,并且对香雪集团旗下控股子公司广东香雪精准医疗技术有限公司的第一款临床研究阶段产品TAEST16001的特性及相关伴随诊断试剂盒的研发进行了简单的描述。     

肿瘤精准免疫诊断综合评估

近年来,肿瘤免疫治疗(cancer immunotherapies)已成为晚期恶性肿瘤治疗的重要手段之一。肿瘤免疫治疗并不直接攻击癌细胞,而是通过调节人体自身免疫系统来抗击肿瘤,有望像抗生素改变抗感染治疗一样改变肿瘤治疗范式。抗PD-1/L1和抗CTLA-4抗体药物作为肿瘤免疫治疗的代表药物,使晚期癌症患者五年生存率达成了数倍的提升,被认为是真正有希望治愈癌症的治疗方式。然而,肿瘤免疫治疗只对部分患者有效,并且存在耐药、超进展、不良反应等问题。如何准确筛选出最有可能从治疗中获益的人群成为肿瘤免疫治疗研究中的一个重大挑战。目前有多个与免疫治疗相关的生物标志物正在研究中,并且有望被用于临床筛选治疗获益人群;但这些生物标记物也存在很多缺陷。未来,围绕免疫治疗敏感性和副反应的多项指标综合评估可能成为一个趋势。     

免疫检查点疗法：战胜癌症的革命性突破 ——写在2018年诺贝尔生理学或医学奖颁布之际

美国免疫学家詹姆斯·艾利森(James P．Allison)与日本免疫学家本庶佑(Tasuku Honjo)因在免疫检查点治疗方面的贡献而获得了2018年诺贝尔生理学或医学奖．这一发现为免疫治疗开启了一扇新的大门．本文回顾了免疫检查点CTLA-4和PD-1的研究历史,免疫检查点药物的研发和应用进展以及免疫检查点疗法在国内的发展现况,提出了免疫检查疗法目前存在的局限性和解决方法．随着近年来我国在免疫治疗领域巨大的资金投入、一流基础研究平台的建设和优秀人才的回国使得我国在这一领域硕果累累,相信在不久的将来我国的免疫检查点抑制剂将会走出国门,为全人类的癌症事业做出贡献．     

Folate-targeted immunotherapies: Passive and active strategies for cancer

The glycoprotein FRα is a membrane-attached transport protein that is shielded from the immune system in healthy cells. However, it is upregulated in various malignancies, involved in cancer development and is also immunogenic. Furthermore, FRα is a tumor-associated antigen endowed with unique properties, thus rendering it a suitable target for immunotherapeutic development in cancer. Various anti- FRα immunotherapeutic strategies are thus currently being developed and clinically assessed for the treatment of various solid tumors. These approaches include passive anti-FRα immunotherapies, such as monoclonal antibodies, or active immunotherapies, such as CART, folate haptens and vaccines. In this review, we will explore the advances in the field of FRα-based immune therapies and discuss both their successes and shortcomings in the clinical setting.     

Need for aligning the definition and reporting of cytokine release syndrome (CRS) in immuno-oncology clinical trials

As cancer immunotherapies continue to expand across all areas of oncology, it is imperative to establish a standardized approach for defining and capturing clinically important toxicities, such as cytokine release syndrome (CRS). In this paper, we provide considerations for categorizing the variety of adverse events that may accompany CRS and for recognizing that presentations of CRS may differ among various immunotherapies (e.g., monoclonal antibodies, CAR T cell therapies and T cell engagers, which can include bispecific antibodies and other constructs). The goals of this paper are to ensure accurate and consistent identification of CRS in patients receiving immunotherapies in clinical studies to aid in reporting; enable more precise evaluation of the therapeutic risk–benefit profile and cross-study analyses; support evidence-based monitoring and management of important toxicities related to cancer immunotherapies; and improve patient care and outcomes. These efforts will become more important as the number and variety of molecular targets for immunotherapies broaden and as therapies with novel mechanisms continue to be developed.     

Single-cell Analysis Technologies for Immuno-oncology Research: from Mechanistic Delineation to Biomarker Discovery

The successes with immune checkpoint blockade(ICB) and chimeric antigen receptor(CAR)-T-cell therapy in treating multiple cancer types have established immunotherapy as a powerful curative option for patients with advanced cancers. Unfortunately, many patients do not derive benefit or long-term responses, highlighting a pressing need to perform complete investigation of the underlying mechanisms and the immunotherapy-induced tumor regression or rejection.In recent years, a large number of single-cell technologies have leveraged advances in characterizing immune system, profiling tumor microenvironment, and identifying cellular heterogeneity, which establish the foundations for lifting the veil on the comprehensive crosstalk between cancer and immune system during immunotherapies. In this review, we introduce the applications of the most widely used single-cell technologies in furthering our understanding of immunotherapies in terms of underlying mechanisms and their association with therapeutic outcomes. We also discuss how single-cell analyses help to deliver new insights into biomarker discovery to predict patient response rate, monitor acquired resistance, and support prophylactic strategy development for toxicity management. Finally, we provide an overview of applying cutting-edge single-cell spatial-omics to point out the heterogeneity of tumor–immune interactions at higher level that can ultimately guide to the rational design of next-generation immunotherapies.     

Immunological aspects of cancer chemotherapy

Accumulating evidence indicates that the innate and adaptive immune systems make a crucial contribution to the antitumour effects of conventional chemotherapy-based and radiotherapy-based cancer treatments. Moreover, the molecular and cellular bases of the immunogenicity of cell death that is induced by cytotoxic agents are being progressively unravelled, challenging the guidelines that currently govern the development of anticancer drugs. Here, we review the immunological aspects of conventional cancer treatments and propose that future successes in the fight against cancer will rely on the development and clinical application of combined chemo- and immunotherapies.     

Engineering T cells for immunotherapy of primary human hepatocellular carcinoma

Liver cancers, majority of which are primary hepatocellular carcinoma(HCC), continue to be on the rise in the world. Furthermore, due to the lack of effective treatments, liver cancer ranks the 4~(th) most common cause of male cancer deaths. Novel therapies are urgently needed. Over the last few years,immunotherapies, especially the checkpoint blockades and adoptive cell therapies of engineered T cells,have demonstrated a great potential for treating malignant tumors including HCC. In this review, we summarize the current ongoing research of antigen-specific immunotherapies including cancer vaccines and adoptive cell therapies for HCC. We briefly discuss the HCC cancer vaccine and then focus on the antigen-specific T cells genetically engineered with the T cell receptor genes(TCRTs) and the chimeric antigen receptor genes(CARTs). We first review the current options of TCRTs and CARTs immunotherapies for HCC, and then analyze the factors and parameters that may help to improve the design of TCRTs and CARTs to enhance their antitumor efficacy and safety. Our goals are to render readers a panoramic view of the current stand of HCC immunotherapies and provide some strategies to design better TCRTs and CARTs to achieve more effective and durable antitumor effects.     

GM-CSF-secreting cancer immunotherapies: preclinical analysis of the mechanism of action

Granulocyte-macrophage colony-stimulating factor (GM-CSF)-secreting tumor cell immunotherapies have demonstrated long-lasting, and specific anti-tumor immune responses in animal models. The studies reported here specifically evaluate two aspects of the immune response generated by such immunotherapies: the persistence of irradiated tumor cells at the immunization site, and the breadth of the immune response elicited to tumor associated antigens (TAA) derived from the immunotherapy. To further define the mechanism of GM-CSF-secreting cancer immunotherapies, immunohistochemistry studies were performed using the B16F10 melanoma tumor model. In contrast to previous reports, our data revealed that the irradiated tumor cells persisted and secreted high levels of GM-CSF at the injection site for more than 21 days. Furthermore, dense infiltrates of dendritic cells were observed only in mice treated with GM-CSF-secreting B16F10 cells, and not in mice treated with unmodified B16F10 cells with or without concurrent injection of rGM-CSF. In addition, histological studies also revealed enhanced neutrophil and CD4+ T cell infiltration, as well as the presence of apoptotic cells, at the injection site of mice treated with GM-CSF-secreting tumor cells. To evaluate the scope of the immune response generated by GM-CSF-secreting cancer immunotherapies, several related B16 melanoma tumor cell subclones that exist as a result of genetic drift in the original cell line were used to challenge mice previously immunized with GM-CSF-secreting B16F10 cells. These studies revealed that GM-CSF-secreting cancer immunotherapies elicit T cell responses that effectively control growth of related but antigenically distinct tumors. Taken together, these studies provide important new insights into the mechanism of action of this promising novel cancer immunotherapy. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Neural regulation of drug resistance in cancer treatment

The treatment of cancer has made great progress. However, drug resistance remains problematic. Multiple physiologic processes of tumor development can be dominated by central and sympathetic nervous systems. The interactions between the nervous system, immune system, and tumor occur consistently and dynamically. Recent evidence suggests that nerves and neural signals are intimately involved in the development of resistance to cancer therapies. In this review, we will provide an overview of the recent progress in this rapidly growing area and discuss the potential new strategies for targeting the neural signaling pathway to improve the effectiveness of chemotherapies, targeted therapies, and immunotherapies.     

胶质瘤的免疫治疗策略及进展

胶质瘤是最常见的原发性颅内肿瘤之一,具有较高的发病率及死亡率。目前,传统的手术治疗辅助放化疗效果不佳。肿瘤的免疫治疗作为一种新兴的疗法在胶质瘤的治疗中已经取得了一定的疗效。本文将全面的总结归纳胶质瘤的三类免疫治疗方法:主动免疫疗法、被动免疫疗法和免疫调节疗法的内容以及现阶段的进展,并提出胶质瘤的免疫治疗潜在的问题:如接受免疫治疗的患者的免疫状态评估体系不健全、缺乏个性化治疗手段、经济效益以及伦理等问题。同时本文将提出免疫治疗在胶质瘤应用上的展望:1)采用手术治疗、放化疗与免疫治疗相结合的立体式鸡尾酒疗法,在增强各种治疗方法疗效的同时弥补传统治疗方法的不足;2)寻找合适的免疫治疗靶点;3)重点研究结合了过继性细胞免疫治疗与体液免疫治疗优势的治疗方法:嵌合抗原受体修饰的T细胞治疗胶质瘤。