CAR-T联合疗法治疗实体瘤的研究进展

CAR-T疗法(chimeric antigen receptor T-cell immunotherapy)即嵌合抗原受体T细胞免疫疗法,是目前肿瘤免疫治疗中较有潜力的策略之一^[1],已成功应用于多种血液肿瘤的治疗。但CAR-T疗法在治疗实体瘤领域进展缓慢,存在肿瘤微环境的限制、细胞因子释放综合征以及严重的脱靶效应等诸多挑战^[2]。与单一靶向治疗相比,CAR-T联合疗法为改进肿瘤治疗方法提供了新的方向。综述目前常用的CAR-T联合治疗策略,针对CAR-T疗法在实体瘤治疗领域面临的主要挑战,探讨提高CAR-T疗效的潜在方案。     

逆转录病毒介导的HSV－tk在肿瘤基治疗中的应用

本实验将ＨＳＶ－ｔｋ基因构建在逆转录病毒载体ＰＬＸＳＮｎｅｏ上,经ＰＡ３１７包装后,筛选出５ｘ１０￣５ｐｆｕ／ｍｌ的ＴＫ包装细胞。用该细胞培养上清感染体外培养细胞,并用Ｇａｎｃｉｃｌｏｖｉｒ－ＧＣＶ处理,可以对增殖的细胞产生细胞毒害作用。细胞增殖速度越快,细胞毒害作用越强。在体内实验中,将ＴＫ细胞直接注射到移植瘤中或与瘤组织悬液混合接种同种小鼠。再用ＧＣＶ治疗,对肿瘤有较强的生长抑制作用。     

Suicide Gene Therapy for Intrinsically Drug Resistant Solid Tumors

Abstract

The failure of available anticancer drugs to cure the common human solid tumors is thought to be caused by their poor selective toxicity. As demonstrated herein, suicide gene therapy offers the potential to improve selective toxicity.     

Diffusion-Weighted MRI Is Insensitive to Changes in the Tumor Microenvironment Induced by Antiangiogenic Therapy

Antiangiogenic treatment (AAT) used in combination with radiation therapy or chemotherapy is a promising strategy for the treatment of several cancer diseases. The vascularity and oxygenation of tumors may be changed significantly by AAT, and consequently, a noninvasive method for monitoring AAT-induced changes in these microenvironmental parameters is needed. The purpose of this study was to evaluate the potential usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI). DW-MRI was conducted with a Bruker Biospec 7.05-T scanner using four diffusion weightings and diffusion sensitization gradients in three orthogonal directions. Maps of the apparent diffusion coefficient (ADC) were calculated by using a monoexponential diffusion model. Two cervical carcinoma xenograft models (BK-12, HL-16) were treated with bevacizumab, and two pancreatic carcinoma xenograft models (BxPC-3, Panc-1) were treated with sunitinib. Pimonidazole and CD31 were used as markers of hypoxia and blood vessels, respectively, and fraction of hypoxic tissue (HF_Pim) and microvascular density (MVD) were quantified by analyzing immunohistochemical preparations. MVD decreased significantly after AAT in BK-12, HL-16, and BxPC-3 tumors, and this decrease was sufficiently large to cause a significant increase in HF_Pim in BK-12 and BxPC-3 tumors. The ADC maps of treated tumors and untreated control tumors were not significantly different in any of these three tumor models, suggesting that the AAT-induced microenvironmental changes were not detectable by DW-MRI. DW-MRI is insensitive to changes in tumor vascularity and oxygenation induced by bevacizumab or sunitinib treatment.     

A Microenvironment Based Model of Antimitotic Therapy of Gompertzian Tumor Growth

A model of tumor growth, based on two-compartment cell population dynamics, and an overall Gompertzian growth has been previously developed. The main feature of the model is an inter-compartmental transfer function that describes the net exchange between proliferating (P) and quiescent (Q) cells and yields Gompertzian growth for tumor cell population N = P + Q. Model parameters provide for cell reproduction and cell death. This model is further developed here and modified to simulate antimitotic therapy. Therapy decreases the reproduction-rate constant and increases the death-rate constant of proliferating cells with no direct effect on quiescent cells. The model results in a system of two ODE equations (in N and P/N) that has an analytical solution. Net tumor growth depends on support from the microenvironment. Indirectly, this is manifested in the transfer function, which depends on the proliferation ratio, P/N. Antimitotic therapy will change P/N, and the tumor responds by slowing the transfer rate from P to Q. While the cellular effects of therapy are modeled as dependent only on antimitotic activity of the drug, the tumor response also depends on the tumor age and any previous therapies—after therapy, it is not the same tumor. The strength of therapy is simulated by the parameter λ, which is the ratio of therapy induced net proliferation rate constant versus the original. A pharmacodynamic factor inversely proportional to tumor size is implemented. Various chemotherapy regimens are simulated and the outcomes of therapy administered at different time points in the life history of the tumor are explored. Our analysis shows: (1) for a constant total dose administered, a decreasing dose schedule is marginally superior to an increasing or constant scheme, with more pronounced benefit for faster growing tumors, (2) the minimum dose to stop tumor growth is age dependent, and (3) a dose-dense schedule is favored. Faster growing tumors respond better to dose density.     

循环肿瘤细胞在女性实体器官肿瘤中的研究进展

循环肿瘤细胞(circulating tumor cells,CTCs)指的是从实体的肿瘤或转移的病灶进入外周血液循环的恶性肿瘤细胞。自发现以来,随着其检验技术日趋成熟,循环肿瘤细胞(CTCs)日渐成为肿瘤学炙手可热的研究对象。因为它将通过外周血的检验来实现监测肿瘤的发生、发展、转移、复发等情况,相对于肿瘤实体活检,"液体活检"不仅让患者易于接受,更有利于医务工作者监测病情变化。本文综述了循环肿瘤细胞(CTCs)的检测方法并综述了循环肿瘤细胞在女性实体肿瘤--乳腺癌、卵巢癌、宫颈癌、子宫内膜癌中的研究进展。其中着重介绍了其在早期乳腺癌及复发转移性乳腺癌中的重大意义以及在评价治疗效果中的分子学特征。实践表明,循环肿瘤细胞(CTCs)与HE-4、CA125的联合应用在评估卵巢癌化疗敏感性中也具有重要的临床意义。     

Frequent Alteration of the Tumor Suppressor Gene APC in Sporadic Canine Colorectal Tumors

Sporadic canine colorectal cancers (CRCs) should make excellent models for studying the corresponding human cancers. To molecularly characterize canine CRC, we investigated exonic sequence mutations of adenomatous polyposis coli (APC), the best known tumor suppressor gene of human CRC, in 23 sporadic canine colorectal tumors, including 8 adenomas and 15 adenocarcinomas, via exon-resequencing analysis. As a comparison, we also performed the same sequencing analysis on 10 other genes, either located at human 5q22 (the same locus as APC) or 18q21 (also frequently altered in human CRC), or known to play a role in human carcinogenesis. We noted that APC was the most significantly mutated gene in both canine adenomas and adenocarcinomas among the 11 genes examined. Significantly, we detected large deletions of ≥10 bases, many clustered near the mutation cluster region, as well as single or two base deletions in ∼70% canine tumors of both subtypes. These observations indicate that like in the human, APC is also frequently altered in sporadic colorectal tumors in the dog and its alteration is an early event in canine colorectal tumorigenesis. Our study provides further evidence demonstrating the molecular similarity in pathogenesis between sporadic human and canine CRCs. This work, along with our previous copy number abnormality study, supports that sporadic canine CRCs are valid models of human CRCs at the molecular level.     

抗血管生成治疗实体肿瘤正常化期间微环境对血液灌注的影响

目的 研究实体肿瘤抗肿瘤血管生成治疗作用下,血管正常化期肿瘤血管微环境动力学参数的变化（包括渗透率、水力传导系数、胶体渗透压、表面积与体积的比例和血管管径）对血液灌注的影响.方法 数值模拟肿瘤血管止常化期过程中的血液灌注.设血液为不可压缩牛顿流体,肿瘤内间质流动遵循Darcy定律,管内流量用扩展的Poiseuille定律,跨壁流量采用Starling定律.用差分迭代法数值计算肿瘤血液灌注组织间质压强.结果 在＂血管止常化窗口期＂,肿瘤组织间质压强下降,压强梯度增大.结论 抗血管生成治疗不仅抑制了肿瘤血管生成,而且随肿瘤血管血液动力学参数的变化,在＂血管正常化窗口期＂改善了肿瘤血液动力学环境,有利于其他治疗肿瘤药物的输运.抗肿瘤血管生成和其它方法联合可望有较好的疗效.     

Parameters of Tumor Microenvironment Determine Effectiveness of Anti-PD-1/PD-L1 Therapy

Biochemistry (Moscow) - Undoubtedly, one of the most promising approaches to the treatment of cancer is creation of the pathogenetically based therapeutic drugs. Researchers from all over the world...     

Microfluidic Device for Recreating a Tumor Microenvironment in Vitro

We have developed a microfluidic device that mimics the delivery and systemic clearance of drugs to heterogeneous three-dimensional tumor tissues in vitro. Nutrients delivered by vasculature fail to reach all parts of tumors, giving rise to heterogeneous microenvironments consisting of viable, quiescent and necrotic cell types. Many cancer drugs fail to effectively penetrate and treat all types of cells because of this heterogeneity. Monolayers of cancer cells do not mimic this heterogeneity, making it difficult to test cancer drugs with a suitable in vitro model. Our microfluidic devices were fabricated out of PDMS using soft lithography. Multicellular tumor spheroids, formed by the hanging drop method, were inserted and constrained into rectangular chambers on the device and maintained with continuous medium perfusion on one side. The rectangular shape of chambers on the device created linear gradients within tissue. Fluorescent stains were used to quantify the variability in apoptosis within tissue. Tumors on the device were treated with the fluorescent chemotherapeutic drug doxorubicin, time-lapse microscopy was used to monitor its diffusion into tissue, and the effective diffusion coefficient was estimated. The hanging drop method allowed quick formation of uniform spheroids from several cancer cell lines. The device enabled growth of spheroids for up to 3 days. Cells in proximity of flowing medium were minimally apoptotic and those far from the channel were more apoptotic, thereby accurately mimicking regions in tumors adjacent to blood vessels. The estimated value of the doxorubicin diffusion coefficient agreed with a previously reported value in human breast cancer. Because the penetration and retention of drugs in solid tumors affects their efficacy, we believe that this device is an important tool in understanding the behavior of drugs, and developing new cancer therapeutics.Download video file.^{(95M, mov)}     

VEGF/VEGFR-Targeted Therapy and Immunotherapy in Non-small Cell Lung Cancer: Targeting the Tumor Microenvironment

Non-small cell lung cancer (NSCLC) is the leading cause of death by cancer worldwide. Despite developments in therapeutic approaches for the past few decades, the 5-year survival rate of patients with NSCLC remains low. NSCLC tumor is a complex, heterogeneous microenvironment, comprising blood vessels, cancer cells, immune cells, and stroma cells. Vascular endothelial growth factors (VEGFs) are a major mediator to induce tumor microvasculature and are associated with the progression, recurrence, and metastasis of NSCLC. Current treatment medicines targeting VEGF/VEGF receptor (VEGFR) pathway, including neutralizing antibodies to VEGF or VEGFR and receptor tyrosine kinase inhibitors, have shown good treatment efficacy in patients with NSCLC. VEGF is not only an important angiogenic factor but also an immunomodulator of tumor microenvironment (TME). VEGFs can suppress antigen presentation, stimulate activity of regulatory T (Treg) cells, and tumor-associated macrophages, which in turn promote an immune suppressive microenvironment in NSCLC. The present review focuses on the angiogenic and non-angiogenic functions of VEGF in NSCLC, especially the interaction between VEGF and the cellular components of the TME. Additionally, we discuss recent preclinical and clinical studies to explore VEGF/VEGFR-targeted compounds and immunotherapy as novel approaches targeting the TME for the treatment of NSCLC.     

Serial Low Doses of Sorafenib Enhance Therapeutic Efficacy of Adoptive T Cell Therapy in a Murine Model by Improving Tumor Microenvironment

Requirements of large numbers of transferred T cells and various immunosuppressive factors and cells in the tumor microenvironment limit the applications of adoptive T cells therapy (ACT) in clinic. Accumulating evidences show that chemotherapeutic drugs could act as immune supportive instead of immunosuppressive agents when proper dosage is used, and combined with immunotherapy often results in better treatment outcomes than monotherapy. Controversial immunomodulation effects of sorafenib, a multi-kinases inhibitor, at high and low doses have been reported in several types of cancer. However, what is the range of the low-dose sorafenib will influence the host immunity and responses of ACT is still ambiguous. Here we used a well-established E.G7/OT-1 murine model to understand the effects of serial low doses of sorafenib on both tumor microenvironment and transferred CD8+ T cells and the underlying mechanisms. Sorafenib lowered the expressions of immunosuppressive factors, and enhanced functions and migrations of transferred CD8+ T cells through inhibition of STAT3 and other immunosuppressive factors. CD8+ T cells were transduced with granzyme B promoter for driving imaging reporters to visualize the activation and distribution of transferred CD8+ T cells prior to adoptive transfer. Better activations of CD8+ T cells and tumor inhibitions were found in the combinational group compared with CD8+ T cells or sorafenib alone groups. Not only immunosuppressive factors but myeloid derived suppressive cells (MDSCs) and regulatory T cells (Tregs) were decreased in sorafenib-treated group, indicating that augmentation of tumor inhibition and function of CD8+ T cells by serial low doses of sorafenib were via reversing the immunosuppressive microenvironment. These results revealed that the tumor inhibitions of sorafenib not only through eradicating tumor cells but modifying tumor microenvironment, which helps outcomes of ACT significantly.     

肿瘤微环境中相关细胞的研究进展

肿瘤的微环境对肿瘤的发生,发展具有重要的意义。实体瘤中除肿瘤细胞外存在大量的非肿瘤细胞,如肿瘤闻质细胞、成纤维细胞、血管内皮细胞、免疫细胞、脂肪细胞等等,这一系列的细胞与肿瘤细胞相互作用,通过一系列的因子分泌而促使肿瘤的进一步的恶化,目前传统的抗肿瘤药物研究往往局限于肿瘤细胞本身而忽略了肿瘤周围的细胞作用,使得肿瘤久治不愈。将来的药物开发应该围绕肿瘤细胞为主体的同时,兼顾微环境中的其他细胞,多靶点治疗肿瘤,真正实现肿瘤的治愈。     

通过模拟胚胎微环境逆转肿瘤的研究进展

肿瘤的发生和发展源于一小部分具有自我更新能力的肿瘤干细胞。胚胎干细胞也具有自我更新和多向分化的特性。胚胎干细胞特异的基质微环境能够提供干细胞正常生长的调控分子,在细胞不断更新的情况下,使增殖和分化达到平衡。受胚胎干细胞调节的基质或胚胎微环境作用于肿瘤细胞,可以使肿瘤细胞获得更多的分化表型,显著降低其恶性程度,抑制肿瘤细胞的侵袭行为。进一步的分子机制研究发现,在肿瘤细胞中高表达的Nodal蛋白会抑制肿瘤细胞分化,而胚胎干细胞分泌的糖基化Lefty蛋白可以负反馈调节Nodal蛋白的作用,从而降低肿瘤细胞的恶性程度。利用组织工程来模拟胚胎干细胞微环境,保留Lefty蛋白,从而逆转肿瘤的方法具有广阔的前景。     

肿瘤微环境中相关细胞的研究进展

肿瘤的微环境对肿瘤的发生,发展具有重要的意义。实体瘤中除肿瘤细胞外存在大量的非肿瘤细胞,如肿瘤间质细胞、成纤维细胞、血管内皮细胞、免疫细胞、脂肪细胞等等,这一系列的细胞与肿瘤细胞相互作用,通过一系列的因子分泌而促使肿瘤的进一步的恶化,目前传统的抗肿瘤药物研究往往局限于肿瘤细胞本身而忽略了肿瘤周围的细胞作用,使得肿瘤久治不愈。将来的药物开发应该围绕肿瘤细胞为主体的同时,兼顾微环境中的其他细胞,多靶点治疗肿瘤,真正实现肿瘤的治愈。     

Induction of Oxidative Stress in Tumor Cells: A New Strategy for Drug Therapy of Malignant Tumors

Biophysics - Abstract—Tumor cells have a higher basal ROS level than normal cells. This phenomenon may provide grounds for the development of novel antitumor drugs that are capable of...     

Tumor Microenvironment Macrophage Inhibitory Factor Directs the Accumulation of Interleukin-17-producing Tumor-infiltrating Lymphocytes and Predicts Favorable Survival in Nasopharyngeal Carcinoma Patients

The accumulation of an intratumoral CD4⁺ interleukin-17-producing subset (Th17) of tumor-infiltrating lymphocytes (TILs) is a general characteristic in many cancers. The relationship between the percentage of Th17 cells and clinical prognosis differs among cancers. The mechanism responsible for the increasing percentage of such cells in NPC is still unknown, as is their biological function. Here, our data showed an increase of Th17 cells in tumor tissues relative to their numbers in normal nasopharynx tissues or in the matched peripheral blood of NPC patients. Th17 cells in tumor tissue produced more IFNγ than did those in the peripheral blood of matched NPC patients and healthy controls. We observed high levels of CD154, G-CSF, CXCL1, IL-6, IL-8, and macrophage inhibitory factor (MIF) out of 36 cytokines examined in tumor tissue cultures. MIF promoted the generation and recruitment of Th17 cells mediated by NPC tumor cells in vitro; this promoting effect was mainly dependent on the mammalian target of rapamycin pathway and was mediated by the MIF-CXCR4 axis. Finally, the expression level of MIF in tumor cells and in TILs was positively correlated in NPC tumor tissues, and the frequency of MIF-positive TILs was positively correlated with NPC patient clinical outcomes. Taken together, our findings illustrate that tumor-derived MIF can affect patient prognosis, which might be related to the increase of Th17 cells in the NPC tumor microenvironment.     

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。