溶瘤病毒靶向治疗肿瘤的策略

近年来,随着国内外几款溶瘤病毒制剂的相继上市,溶瘤病毒疗法成为肿瘤免疫治疗的焦点。溶瘤病毒可选择性感染并裂解肿瘤细胞,同时释放肿瘤相关抗原激活机体的抗肿瘤免疫反应,达到杀伤肿瘤细胞和抑制肿瘤生长的目的。溶瘤病毒对肿瘤的靶向杀伤作用决定了其安全性和溶瘤效果。为了开发出安全高效的溶瘤病毒,目前主要采用以下策略：利用某些病毒载体对肿瘤细胞的天然靶向性,使溶瘤病毒选择性地在肿瘤细胞内复制并杀伤肿瘤细胞;或者对病毒基因组进行缺失和插入等修饰,通过靶向肿瘤细胞特异性表面受体、胞内信号通路或者肿瘤微环境等提高溶瘤病毒的肿瘤靶向性。其中,肿瘤微环境中的低氧状态、新血管生成以及免疫抑制状态等都可成为溶瘤病毒的靶点。而溶瘤病毒通过表达细胞因子和免疫检查点抑制剂,或者与CAR-T细胞联合作用,靶向调节肿瘤微环境中免疫抑制状态,成为提高溶瘤病毒肿瘤靶向性的常用方法。本文将对以上溶瘤病毒靶向治疗肿瘤策略的研究进展进行综述。     

溶瘤病毒调控肿瘤微环境及联合治疗的研究进展

溶瘤病毒是一类天然的或经改造后获得具有靶向杀伤癌细胞能力的病毒,除了能特异性杀伤肿瘤细胞外,经改造后的溶瘤病毒对肿瘤微环境的调控作用也会影响其最终疗效.通过调控肿瘤微环境中肿瘤细胞抗原的表达、免疫抑制状态、肿瘤相关成纤维细胞及肿瘤血管新生等,溶瘤病毒为肿瘤的治疗提供了更为系统的治疗策略;联合免疫检查点抑制剂的使用能使两者获得协同和互补的功效,进一步提升了肿瘤全面和有效的治疗.本文将对溶瘤病毒对肿瘤微环境调控作用及联合治疗的研究进展进行综述.     

肠道病毒溶瘤机制的研究进展

肠道病毒是引起人类无症状或轻微病变的病毒,以此为基础的溶瘤病毒已受到广泛关注。大量实验结果显示,利用肠道病毒靶向杀伤肿瘤(溶瘤)具有较好的安全性和有效性,但不同肠道病毒作为溶瘤病毒的作用机制尚不完全清楚。本文就溶瘤性肠道病毒的分子机制、肠道病毒的改造与临床试验等方面的研究进展进行综述。     

溶瘤病毒与肿瘤治疗

研究发现有些病毒具有特异性感染并杀伤肿瘤细胞的能力,这类病毒被称为“溶瘤病毒”。天然的溶瘤病毒有细小病毒、呼肠孤病毒、新城疫病毒、水疱性口炎病毒、麻疹病毒等。有些病毒缺失一些病毒基因的突变体,具有溶瘤病毒的特性,其中包括腺病毒、疱疹病毒和甲型流感病毒。通过病毒基因工程可以进一步提高溶瘤病毒的安全性和杀伤肿瘤细胞的效果。一系列体外、动物模型和临床的试验证实,不少溶瘤病毒具有良好的安全性和抑制肿瘤的能力。     

溶瘤性流感病毒的研究进展

溶瘤病毒疗法属于免疫治疗的手段之一。其可通过病毒特异性地感染裂解肿瘤细胞和激活肿瘤免疫两种途径来达到杀伤肿瘤的目的;同传统疗法比,具有安全、高效、副作用小等优点。流感病毒自1900年代首次发现其可能作为“有益”的病毒缓解白血病病情以来,不断有研究证明流感病毒具有杀伤肿瘤细胞的能力;利用反向遗传操作技术对病毒进行改造,有望将其发展成为一种更加安全、有效的肿瘤治疗生物制剂。本文将对近年来溶瘤流感病毒利用肿瘤分泌的胰蛋白酶促进病毒感染并在RAS基因突变导致干扰素缺陷的肿瘤中复制来提高肿瘤靶向性,编码CTLA-4的单链抗体或HER-2增强流感病毒的抗癌特异性及作为外源基因IL-2、IL-15、GM-CSF和抗PD-1单克隆抗体的载体激活机体免疫几个方向进行综述。     

溶瘤腺病毒治疗肿瘤的研究进展

溶瘤腺病毒是一种改造过的能够选择性地在肿瘤细胞中复制,并能够杀死肿瘤细胞的腺病毒,目前已经应用于肿瘤治疗中。但是因为肿瘤的复杂性以及高突变性,所以提高溶瘤腺病毒对肿瘤的有效性,选择性和安全性成为了主要的研究方向。能够在体内正常表达shRNA、细胞因子、自杀基因、基质修饰蛋白等治疗性基因的溶瘤腺病毒具有比单纯的溶瘤腺病毒更强的抗肿瘤活性。而具有肿瘤特异性启动子,尤其是双调控启动子的溶瘤腺病毒对肿瘤细胞具有更强的选择性杀伤作用。另外用脂质体、PEG聚合物、纳米颗粒、多肽等包裹的溶瘤腺病毒能够减少病毒的免疫原性以及对肝脏的毒性,增强了全身给药途径的抗肿瘤活性。特别是用PEG连上抗体、小肽、细胞因子和配体,能显著提高溶瘤腺病毒的选择性。因此,整合病毒载体与非病毒载体的优点并与免疫治疗相结合,是一个很有希望的提高病毒靶向治疗效果的策略。     

溶瘤病毒的肿瘤治疗进展

溶瘤病毒(oncolytic viruses, OVs)是一种具有发展潜力的肿瘤免疫治疗方法,是天然或经基因改造后对肿瘤具有靶向性的DNA病毒和RNA病毒。溶瘤病毒具有肿瘤靶向性、作为载体传递多种转基因表达、诱导免疫性细胞死亡和促进抗肿瘤免疫反应等优点,而且具有可耐受的安全性。该文将从溶瘤病毒的发展历程、分类、作用机制、改造策略、生物标志物和临床应用的研究现状和现存问题展开综述。     

溶瘤病毒与肿瘤治疗

溶瘤病毒是目前恶性肿瘤治疗领域中较有前景的新型基因治疗药物,其通过选择性杀伤肿瘤细胞和诱导机体产生特异的抗肿瘤免疫两种途径来实现肿瘤靶向治疗的目的,从而达到较好的抗肿瘤效果。现对溶瘤病毒的溶瘤机制、临床研究、联合治疗和当前挑战及未来展望等方面进行综述。     

溶瘤麻疹病毒的临床研究与转化进展

肿瘤已成为危及全人类生命的重大疾病,虽然常规治疗手段如手术及放疗/化疗等不断发展,但对某些复发、难治性恶性肿瘤仍然束手无策,亟需安全、有效可行的治疗手段。在肿瘤基因治疗领域,能在肿瘤细胞内大量自我复制并选择性杀伤肿瘤细胞的溶瘤病毒(Oncolytic virus)逐渐崭露头角,目前溶瘤病毒抗瘤治疗备受关注。其中溶瘤麻疹病毒疫苗株(MV-Edm)因其可靠的安全性和优良的溶瘤效果已进入几项临床试验,为推动其临床转化奠定了基础,期望为肿瘤患者带来治疗上的突破。本文就目前溶瘤麻疹病毒的临床研究与转化进展的相关研究成果进行综述。     

溶瘤病毒联合CAR-T细胞治疗实体瘤研究进展

嵌合抗原受体修饰的T细胞(chimeric antigen receptor T cells, CAR-T)疗法属于肿瘤免疫治疗的范畴。该疗法在血液系统恶性肿瘤治疗中表现优异,但在实体瘤治疗中存在诸多挑战。近年来,溶瘤病毒(oncolytic viruses, OVs)在针对黑色素瘤、脑胶质瘤等实体瘤适应证的临床试验中展现出良好的疗效。溶瘤病毒一方面选择性地在肿瘤细胞中复制杀伤肿瘤细胞,另一方面通过激活机体自身的免疫系统发挥抗肿瘤作用。因此,溶瘤病毒与免疫检查点抑制剂、肿瘤浸润淋巴细胞疗法(tumor infiltrating lymphocytes, TIL)等免疫疗法的联合应用也在广泛开展。目前研究表明,溶瘤病毒不仅能够增加CAR-T细胞的抗肿瘤活性,而且通过传递肿瘤相关抗原或特异性抗原来增强CAR-T细胞对肿瘤的杀伤作用,同时溶瘤病毒还可以帮助CAR-T细胞克服免疫抑制性的肿瘤微环境。两种疗法的联合应用在临床前研究中展现出了良好的疗效和安全性,能够解决CAR-T在实体瘤治疗领域的瓶颈,具有广阔的临床转化前景。本文就溶瘤病毒与CAR-T细胞联合治疗实体瘤的药效及相关机制研究展开论述...     

Lung cancer and oncolytic virotherapy——enemy's enemy

Lung cancer is one of the malignant tumors that seriously threaten human health worldwide, while the covid-19 virus has become people's nightmare after the coronavirus pandemic. There are too many similarities between cancer cells and viruses, one of the most significant is that both of them are our enemies. The strategy to take the advantage of the virus to beat cancer cells is called Oncolytic virotherapy. When immunotherapy represented by immune checkpoint inhibitors has made remarkable breakthroughs in the clinical practice of lung cancer, the induction of antitumor immunity from immune cells gradually becomes a rapidly developing and promising strategy of cancer therapy. Oncolytic virotherapy is based on the same mechanisms that selectively kill tumor cells and induce systemic anti-tumor immunity, but still has a long way to go before it becomes a standard treatment for lung cancer. This article provides a comprehensive review of the latest progress in oncolytic virotherapy for lung cancer, including the specific mechanism of oncolytic virus therapy and the main types of oncolytic viruses, and the combination of oncolytic virotherapy and existing standard treatments. It aims to provide new insights and ideas on oncolytic virotherapy for lung cancer.     

溶瘤I型单纯疱疹病毒的研究进展

溶瘤病毒(Oncolytic virus,OV)是可以靶向感染并杀伤肿瘤细胞的一类病毒,其中溶瘤I型单纯疱疹病毒(Oncolytic herpes simplex virus type 1,OHSV-1)是目前研究最多的溶瘤病毒之一,可通过多种策略进行构建,已有多种OHSV-1进入临床试验,大量结果显示其具有较好的安全性和有效性。本文主要介绍OHSV-1的分子生物学特性与优势、主要的开发及靶向性策略、各类OHSV-1的研究进展以及目前存在的问题等。     

Developing oncolytic viruses for clinical use: A consortium approach

The use of oncolytic viruses forms an appealing approach for cancer treatment. On the one hand the viruses replicate in, and kill, tumor cells, leading to their intra-tumoral amplification. On the other hand the viral infection will activate virus-directed immune responses, and may trigger immune responses directed against tumor cells and tumor antigens. To date, a wide variety of oncolytic viruses is being developed for use in cancer treatment. While the development of oncolytic viruses has often been initiated by researchers in academia and other public institutions, a large majority of the final product development and the testing of these products in clinical trials is industry led. As a consequence relatively few pre-clinical and clinical studies evaluated different oncolytic viruses in competitive side-by-side preclinical or clinical studies. In this review we will summarize the steps and considerations essential in the development and characterization of oncolytic viruses, and describe our multidisciplinary academic consortium, which involves a dozen departments in three different Dutch universities, collaborating in the development of oncolytic viruses. This consortium has the ambition to develop a small series of oncolytic viruses and to evaluate these in various cancers.     

Oncolytic viruses: what to expect from their use in cancer treatment

Oncolytic viruses are biologic agents able to selectively infect and destroy cancer cells while sparing the normal ones. Furthermore, they also stimulate the host immune system to combat the tumor growth and to promote tumor removal. This review thoroughly describes different types of viruses developed for targeting specific cancers, as well as the strategies to improve the efficacy and safety of oncolytic virotherapy. It also explores how their potential as anticancer agents may be enhanced through combination with other traditional therapies, such as chemotherapy or more recent approaches, such as checkpoint inhibitors. There are many oncolytic viruses currently being tested in clinical trials for the treatment of various types of cancer, suggesting that this approach could become the near future of the oncology field.     

Determinants of the efficacy of viro-immunotherapy: A review

Oncolytic virus immunotherapy is rapidly gaining interest in the field of immunotherapy against cancer. The minimal toxicity upon treatment and the dual activity of direct oncolysis and immune activation make therapy with oncolytic viruses (OVs) an interesting treatment modality. The safety and efficacy of several OVs have been assessed in clinical trials and, so far, the Food and Drug Administration (FDA) has approved one OV. Unfortunately, most treatments with OVs have shown suboptimal responses in clinical trials, while they appeared more promising in preclinical studies, with tumours reducing after immune cell influx. In several clinical trials with OVs, parameters such as virus replication, virus-specific antibodies, systemic immune responses, immune cell influx into tumours and tumour-specific antibodies have been studied as predictors or correlates of therapy efficacy. In this review, these studies are summarized to improve our understanding of the determinants of the efficacy of OV therapies in humans and to provide insights for future developments in the viro-immunotherapy treatment field.     

可复制性单纯疱疹病毒在抗肿瘤方面的应用

单纯疱疹病毒是肿瘤生物治疗中常用的病毒载体之一,可复制性单纯疱疹病毒以其溶瘤效率高、特异性好、可行性强成为近年来研究的热点。其中对溶瘤性单纯疱疹病毒突变株G207的研究开展得早,其溶瘤效果、靶向性及安全性都得到了确认,这也带动了可复制性单疱病毒应用的发展,目前已研究出多种溶瘤单纯疱疹病毒突变株。本文就近几年可复制性单纯疱疹病毒在抗肿瘤方面的研究现状加以综述,以探讨其临床治疗肿瘤的潜在价值及可行性。     

靶向宿主代谢重编程的溶瘤病毒调控策略

溶瘤病毒是一类天然的或经过基因编辑后能特异性在肿瘤细胞中复制、发挥抗肿瘤效应的病毒。溶瘤病毒的抗肿瘤效应主要通过以下两个方面实现：a. 直接的溶瘤效应，例如诱导肿瘤细胞发生凋亡、促使细胞裂解等；b. 溶瘤病毒作为一种激活免疫的药物，通过诱导机体产生强烈的抗肿瘤免疫，达到清除肿瘤的目的。溶瘤病毒疗法作为免疫疗法的一个重要分支，因其具有肿瘤特异性，便于基因改造等优点，成为该领域的研究热点。截至目前，处在临床实验招募和完成阶段的溶瘤病毒疗法虽然已达100多例，但已批准上市的产品仅有4款。溶瘤疗法应用于肿瘤治疗领域还面临着诸多挑战。因此，系统性回顾溶瘤病毒的改造策略，深入了解溶瘤病毒的生物学过程显得尤为必要。病毒依赖于宿主完成复制、增殖过程，其生物学过程与宿主的代谢状态密切相关。肿瘤的标志性特征为代谢重编程，即肿瘤细胞重新构建代谢网络以满足指数生长和增殖的需求并防止氧化应激的过程。通常包括糖酵解的增强和谷氨酰胺分解，以及线粒体功能和氧化还原稳态的变化。通过靶向宿主代谢重编程增强溶瘤病毒的复制、溶瘤能力是当前极具前景的方向。本文综述溶瘤病毒的临床应用现状及与代谢相关的调控机制，为进一步开发新型溶瘤病毒以及联用方式提供新的思路。     

Current landscape and perspective of oncolytic viruses and their combination therapies

Oncolytic virotherapy has become an important strategy in cancer immunotherapy. Oncolytic virus (OV) can reshape the tumor microenvironment (TME) through its replication-mediated oncolysis and transgene-produced anticancer effect, inducing an antitumor immune response and creating favorable conditions for the combination of other therapeutic measures. Extensive preclinical and clinical data have suggested that OV-based combination therapy has definite efficacy and promising prospects. Recently, several clinical trials of oncolytic virotherapy combined with immunotherapy have made breakthroughs. This review comprehensively elaborates the OV types and their targeting mechanisms, the selection of anticancer genes armed in OVs, and the therapeutic modes of action and strategies of OVs to provide a theoretical basis for the better design and construction of OVs and the optimization of OV-based therapeutic strategies.     

Intravenous injection of the oncolytic virus M1 awakens antitumor T cells and overcomes resistance to checkpoint blockade

Reversing the highly immunosuppressive tumor microenvironment (TME) is essential to achieve long-term efficacy with cancer immunotherapy. Despite the impressive clinical response to checkpoint blockade in multiple types of cancer, only a minority of patients benefit from this approach. Here, we report that the oncolytic virus M1 induces immunogenic tumor cell death and subsequently restores the ability of dendritic cells to prime antitumor T cells. Intravenous injection of M1 disrupts immune tolerance in the privileged TME, reprogramming immune-silent (cold) tumors into immune-inflamed (hot) tumors. M1 elicits potent CD8⁺ T cell-dependent therapeutic effects and establishes long-term antitumor immune memory in poorly immunogenic tumor models. Pretreatment with M1 sensitizes refractory tumors to subsequent checkpoint blockade by boosting T-cell recruitment and upregulating the expression of PD-L1. These findings reveal the antitumor immunological mechanism of the M1 virus and indicated that oncolytic viruses are ideal cotreatments for checkpoint blockade immunotherapy.Subject terms: Cancer microenvironment, Targeted therapies